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Stuent name *

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Last

Date of birth *

What grade is the student enrolling into? *

Courses Desired (Check all that apply) *

Does the student have a IEP or 504?

Does your child or children receive any of the "Step-Up" Scholarships?

Parent/Guardian Name *

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Last

Parent/Guardian Email *

any agree Stuent

Parent/Guardian Phone *

Permission & Agreement *

I give the academy to evaluate my child for admission to the academy.

I agree to the following charge *