2026–2027 North Park Learning Group Interest Form 😊
Share your interest in NPLG and the program placement you’re considering for the 2026–2027 school year.
Family / Student Contact Information
Student's Name
First Name
Last Name
Parent's/Caregiver's Name
*
First Name
Last Name
Email
*
example@example.com
Daytime Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Street Address
*
Street Address Line 2
City
*
State / Province
*
Postal / Zip Code
*
Student Background
Student's Age
*
Student's Current Grade
*
Please Select
Pre-K
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Other
Student's Current School
*
Describe your child's current educational setting.
*
Please list any learning differences that help make your child awesome, yet may need additional support.
*
Why are you interested in NPLG? What are your goals for your child? (academic, social, etc.)
*
Please provide a brief description of your child's previous schooling.
*
Please highlight any known learning differences, social/emotional needs, and/or experiences that might impact their success in our setting. Please share results of previous testing. Please provide this information even if your student sees an Engage the Brain Learning Specialist.
*
Program Interest
Interested Program & Grade Level Placement
*
Foundations (ages 7-9, grades 2-3)
Connections (ages 9-11, grades 4-5)
Middle School (ages 11-14, grades 6-8)
High School (ages 14+, completed 8th grade+)
Acknowledgement
*
I understand that as a parent of this program, I am solely responsible for my child's education, as this program is a homeschool hybrid. In addition to the curriculum provided on school days, parents will need to supplement and monitor their child's academic progress.
Submit
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