SchoolCues

Learning Lodge Academy

Admission Inquiry

Student Details

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

First Name^*

Last Name^*

Date of Birth (or due date)^*

Gender^*

School Year Applying for^*

Current Grade / Program Enrolled In

Current School Enrolled In

Grade / Program Applying to ^*

Parent/Guardian Information

Title^*

First Name^*

Last Name^*

Relationship to Applicant^*

Email^*

Phone^* (Primary Contact Number)

Phone Type^* (Primary Contact Type)

Address

Address Line 1^*

Address Line 2

City^*

State^*

Zip^*

Country^*

Sibling Information

Do you have a sibling who is currently attending or had attended our school in the past?

Currently attending

Attended in the past

First Sibling Name

First Sibling Year Attended

Second Sibling Name

Second Sibling Year Attended

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.

If yes, please list them in the text field below. If there is no preference please type NONE. *

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.

Please include the names of any students, parents, staff, etc. who recommended Learning Lodge Academy to you. *

7278680067

[email protected]