Enrollment Form

Fathers Full Name*

First NameLast Name

Mothers Full Name*

First NameLast Name

Phone Number*

Please enter a valid phone number.Format: (000) 000-0000.

Email Address*

example@example.com

Child's Full Name*

First NameMiddle NameLast Name

D.O.B

Date

Childs Current Grade*

EnglishSpanishFrenchOther

Child’s Home Address*

Street Address

Street Address Line 2

CityStateZip CodeCountry

Upload your child's last grade report card

Upload a recent photo of your child

Send me a separate photo upload link.

YesNoIn Process

YesNo

Assistive technology (screen reader, speech-to-text, etc.)Testing accommodations (extended time, breaks, etc.)Modified assignments/curriculum1:1 adult support during learning timePhysical assistance (mobility, toileting, feeding, lifting/transfer, hands-on care)Nursing/medical services during the school day

Thank you for sharing.
Families who indicate an IEP, 504 Plan, or additional support needs must schedule a virtual tour before continuing enrollment.

Appointment

Do you have a computer (laptop or desktop) to use for school?Do you have internet that works well for video classes?Do you have a camera and microphone for class?Do you have a quiet place to learn at home?Can a parent/guardian help you at home when you need it?(Especially for younger students.)

Yes, I agree.

Yes, I Aprrove

Signature*

SF RecordTypeId