2019-2020 Academy Lottery Application
By entering your child on The Academy's lottery list, you understand that this does not guarantee enrollment and that you will be notified only if your child is eligible for enrollment. You also understand that should your child's lottery number not be selected, by the lottery, you will need to re-add your child to the list each year. Lottery lists do not get rolled from year to year. Should your phone number, email, address or interest in The Academy change, please contact the school to have your information updated. Should we attempt to reach you and we do not get a response, your student will be removed from the list.
Student Information
Student Last Name (as it appears on the Birth Certificate) *
Your answer
Student First Name (as it appears on the Birth Certificate) *
Your answer
Student's Date of Birth (Format: MM/DD/YYYY) *
Students entering Pre-K MUST turn 4 years old on or before October 1st. Students entering Kindergarten MUST turn 5 years old on or before October 1st. Students entering 1st grade MUST turn 6 on or before October 1st.
Your answer
Student Gender *
Grade for 2019-2020 *
Our Pre-K and Kindergarten programs are 5 days a week. If you are selecting Pre-K or Kindergarten, please select only one session. You cannot add your student to multiple lists. Pre-K and Full Day Kindergarten parents will be required to pay a $100, non-refundable deposit once notified of eligibility.
Current Grade *
Grade level your student will be in for the 2018-2019 school year.
Name of Current School *
If you student has never been in school, type "N/A"
Your answer
Does This Student Have an I.E.P. (Individualized Education Plan) *
Special Education- We will need a copy of the I.E.P. upon notification of eligibility of enrollment but does not affect the lottery process.
Does This Student Have a 504 Plan? *
We will need a copy of the 504 Plan upon notification of eligibility of enrollment but does not affect the lottery process.
Parent/Guardian Information
Parent(s)/Guardian(s) First Name *
Your answer
Parent(s)/Guardian(s) Last Name *
Your answer
Primary Phone Number *
This will be the number we call first should your student become eligible for enrollment.PLEASE USE DASHES!
Your answer
Alternate Phone Number
Your answer
Email Address *
Your answer
Preferred Method of Contact *
Home Address *
Your answer
City *
Your answer
State *
Zip Code *
Your answer
District of Residency *
School district where your home resides. If you are not sure, copy and paste this link into another browser window: http://adams12.org/boundary_locator
Family Enrollment
Is this student a child of a current employee at The Academy? *
If you marked "YES" to the previous question, what is the name and title of the parent/guardian that currently works at The Academy?
Example: Teacher, Custodian, Coach, etc.
Your answer
Does this student currently have siblings attending The Academy? *
If you marked "YES" to the previous question, what is the name of the sibling that has attended The Academy the longest?
Your answer
Did you graduate from The Academy? *
If you marked "YES" to the previous question, what year did you graduate?
Your answer
How did you hear about The Academy? *
Your answer
**BE SURE TO PRINT THIS PAGE FOR YOUR RECORDS PRIOR TO SUBMITTING**
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