Harpswell Coastal Academy
Declaration of Intent to Enroll Form
for the 2017-18 School Year
Please complete this form to enter the lottery for a spot for the 2017-18 school year. Completion of this form does NOT commit your child to taking a spot if one is offered.
I, ________________________________________ (parent/guardian), intend to enroll my child, _________________________________________ (student name) at Harpswell Coastal Academy, beginning in the 2017-18 school year.
We currently reside in the city/town of ____________________ and the student is in ____ grade at ___________________________________________________(student's current school).
Student Date of Birth: ___/___/___
Parent/guardian signature: ________________________________ Date: ___/___/___
Parent phone: ___________________________
Parent email: ____________________________
Mail to: Harpswell Coastal Academy 9 Ash Point Road Harpswell, ME 04079
**** This must be received by Thursday, March 23rd, 2017 at 4pm
to enter our enrollment lottery for the 2017-18 school year. ****