Dolphin STEM Academy Online Private School Application

NOTE: This form is for the FULL school-year enrollment. If you want to enroll in 1 semester/half-year, click here for half-year/1 semester enrollment.

Name*

First NameLast Name

Birth Date*

MonthDayYear

Gender and Race/Ethnicity*

Student's email*

example@example.com

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Country*

Have you been awarded the ESA or EFS by the State of Tennessee?

Yes, I received the ESA or EFSNo.

Tennessee ESA and EFS recipients

must complete this application form instead

which does not require a payment when you submit it.

Please click here to complete the application for

Dolphin STEM Academy for TN ESA and EFS recipients.

Thank you.

Grade Level Applying for (4th - 12th Grade are available. Kindergarten - 3rd Grade are closed.)*

Anticipated start date (at least 5 business days are needed for registration) *

Your School District and Last School Attended*

Student's STEM area(s) of interest*

Are you a NCAA Prospective Student Athlete and in need of NCAA approved courses?*

NoYes, I'm a NCAA Prospective Student Athlete

What is your sport as a student athlete?

Does this student have an IEP or require special education services? If yes, please explain in detail.*

Additional comments/info about the student

Please upload a current photo of the student (headshot), immunization record or exemption letter, student's birth certificate, and school records (transcripts, report cards, standarized tests, etc).*

Browse Files

Do you want to enroll an additional student?*

Yes, I want to enroll an additional student.No, I do not want to enroll an additional student.

2nd Student's Name

First NameLast Name

Birth Date

MonthDayYear

Gender and Race/Ethnicity

Student's email

example@example.com

Grade Level Applying for (4th - 12th Grade are available. Kindergarten - 3rd Grade are closed.)

Anticipated start date (at least 5 business days are needed for registration)

Your School District and Last School Attended

Student's STEM area(s) of interest

Does this student have an IEP or require special education services? If yes, please explain in detail.

Are you a NCAA Prospective Student Athlete and in need of NCAA approved courses?

NoYes, I'm a NCAA Prospective Student Athlete

Additional comments/info about the student

Please upload a current photo of the student (headshot), immunization record or exemption letter, student's birth certificate, and school records (transcripts, report cards, standarized tests, etc).

Browse Files

Do you want to enroll an additional student?

Yes, I want to enroll an additional student.No, I do not want to enroll an additional student.

3rd Student's Name

First NameLast Name

Birth Date

MonthDayYear

Gender and Race/Ethnicity

Student's email

example@example.com

Grade Level Applying for (4th - 12th Grade are available. Kindergarten - 3rd Grade are closed.)

Anticipated start date (at least 5 business days are needed for registration)

Student's STEM area(s) of interest

Your School District and Last School Attended

Does this student have an IEP or require special education services? If yes, please explain in detail.

Additional comments/info about the student

Please upload a current photo of the student (headshot), immunization record or exemption letter, student's birth certificate, and school records (transcripts, report cards, standarized tests, etc).

Browse Files

We don't spam and we don't sell info! We use contact information to get in touch with you about your requested service and programs at Dolphin STEM Academy.

Parent/Guardian Name*

First NameLast Name

Your Relationship to the Student (mother, father, grandmother, aunt, friend, etc.):*

Phone Number*

Area CodePhone Number

Email*

Enter the email address to receive login information.

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Country*

Would you like to add another parent/guardian to the student's school account and profile?*

YesNo

Would you like to receive our promotional emails for events, news, promotions, and more?*

Yes!No

How did you hear about Dolphin STEM Academy?*

FacebookGoogleOther/Referral (Please enter referral name below)Other

2nd Parent/Guardian Name

First NameLast Name

2nd Parent/Guardian's Relationship to the Student (mother, father, grandmother, aunt, friend, etc.):

2nd Parent/Guardian Phone Number

Area CodePhone Number

2nd Parent/Guardian Email

Enter the email address to receive login information.

2nd Parent/Guardian: Would you like to receive our promotional emails for events, news, promotions, and more?

Yes!No

Does your child have a parent or grandparent who is an active duty or retired member of the US armed forces and eligible for our military discount?

NOYES

Upload your proof of military status, and DELETE/HIDE any confidential information. This step is required for the discount codes to appear in the next step.

Browse Files

Military Discount

If your student has an active duty or retired US armed service member as a parent or grandparent, your child qualifies for a discount.

Enter the coupon code below on the coupon section of the registration and payment.

For 1 student enrollment, use code: military1

For 2 student enrollment, use code: military2

For 3 student enrollment, use code: military3

REGISTRATION & PAYMENT:*

FULL PAYMENT DISCOUNT

INDEPENDENT - Online Private School - 8 months/2 Semester Enrollment$2,999.00

INDEPENDENT - Online Private School - 8 months/2 Semester Enrollment Discounted tuition for payment in full. Sibling discount will be automatically applied when you select the number of students to enroll in the total # of students box.