Learning Lodge Academy
Admission/Enquiry form

For families with multiple students who are applying, please submit a separate form for each child who is applying for a spot. Please complete all required sections of this form.

Student Information

Parent/Guardian Information

Address

Sibling Information

Questionnaire

Enrollment Preference (F.S.1002.31(2)(c))

Are you applying with any of the following preferences? Foster Care Placement, LLA Governing Board Member, Dependent child(ren) of Active Duty Military, Court Ordered Custody Change, LLA Employee, or Hope Scholarship.

How did you hear about us?

Let us know how you found us. i.e., internet search, school website, Facebook, friend or family member recommendation, signs, etc.



7273890067

10534 Little Rd, New Port Richey, FL 34654

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