APPLICATION AND ENROLLMENT FORM

Fields marked with an * are required

Language/Lengua
Parent/Guardian First Name*
Parent/Guardian Middle Name
Parent/Guardian Last Name*
Parent/Guardian Email*
Confirm Email*
Parent/Guardian Phone*	Required format: (999) 999-9999 or +1 (999) 999-9999
Security Questions
What is your favorite color?*
What is your favorite movie?*
What is your favorite food?*

Please add your child's First/Last name and add his/her Date of Birth below. If you have multiple children to register, you will be able to add them later in the process.

Student First Name*	Please enter the child's full first name as seen on his/her school report card
Student Last Name*	Please enter the child's full last name as seen on his/her school report card
Student Date of Birth* (mm/dd/yyyy)	[ 10/3/2024 ]
Affiliate*

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