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Student Name

First

Last

Student Address

Address Line 1

Address Line 2

City

State

Zip Code

Date of Birth

Gender

Grade Applying to Enter

Parent/Guardian Name

First

Last

Parent/Guardian Email

Parent/Guardian Phone

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

Yes
No

Does the student have a IEP or 504?

Yes
No

Student to Agreement

File Upload

Drag & Drop Files, Choose Files to Upload

Kindly take a moment to upload the student’s last report card.

Permission & Agreement

I agree and give my permission

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

I affirm that all of the information contained in this application is correct, complete, and honestly presented. I understand that withholding or misrepresenting information in this application may jeopardize my child’s admission.

I waive my right to access confidential information contained in my child’s admission file.

I agree to the following charge

Application Fee – $50.00