Student Interest Form

Student Interest Form

Share your interest in Laissez Fair Digital Academy, located in Maitland at the new PediaBloom location. Please complete this form so we can connect with you about our programs.
Parent Full Name

First NameLast Name
Parent Email Address
example@example.com
Parent Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Student Full Name

First NameLast Name
Student Age
Student's Current Grade
Scholarship Type
Which program(s) are you interested in?
What days and times work best for your family?
Do you have any questions for the founders?
How did you hear about our program?
All Pods run Monday-Thursday.

TechQuest-9:00AM-12:00PM

CoreWorks-12:30PM-3:00PM

Please note there will be a $500 Materials Fee.
Should be Empty: