Request edit access
Madison Elementary 2025-2026 Open Enrollment Application
This is a preliminary application.  The Madison Office will contact you to complete the enrollment process.
Sign in to Google to save your progress. Learn more
Email *
Student Information 2025-2026
(As it appears on birth certificate)
Last Name *
First Name *
Middle Name *
Current Age of Student *
School District *
Current School Name *
Gender *
Is student currently being homeschooled? *
Address *
City *
State *
Zip *
Is this a temporary residence? *
Date of Birth *
MM
/
DD
/
YYYY
State & Country of Birth *
If outside the US, when did the student enter the US? *
MM
/
DD
/
YYYY
Student is currently under disciplinary review or suspension procedures at current school.  (If yes, you must supply documentation,) *
Student has been expelled in the last 180 days. (If yes, you must supply documentation.) *
Grade in August of 2025 *
Parent/Legal Guardian Information:  For Contact Purposes
Parent/Legal Guardian Name *
Relationship *
Address *
City *
State *
Zip *
Preferred Phone Number *
Alternate Phone (If different than above.)
Work Phone Number *
Workplace *
Hours of Employement *
Parent/Legal Guardian Email Address *
Student Resides with *
Required
Sibling Information:  (List only siblings that are or will be attending Madison Academy).
MUST STILL COMPLETE APPLICATION FOR EACH.
Sibling #1 Name
Gender
Clear selection
Grade in August of 2025
Sibling #2 Name
Gender
Clear selection
Grade in August of 2025
How did you hear about Madison?  (Select All That Apply)
Referral - Name of Referral
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Madison Academy.

Does this form look suspicious? Report

Google Forms