Jacksonville School for Autism Inquiry Form

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Thank you for your interest in attending Jacksonville School for Autism.

Please complete this form with your current information about your family.

Please note, this form is used to collect information to determine whether your child meets the criteria of a potential placement opportunity. The completion of this form does not place your student on a wait list.

If your child may be a candidate for a future placement opportunity, a member of our admissions team will reach out to you to request more information and schedule an observation. The completion of the observation does not guarantee enrollment.

We keep all inquiries on file to evaluate for the following school year and will keep you on our list!

ENROLLMENT FOR THE 2025-2026 SCHOOL YEAR HAS ENDED.

Families that have completed this form will be considered for enrollment for the 2026-2027 school year.

Please note, JSA is a private school with limited placement opportunities every year. This list is for informational purposes only and is not evaluated in a linear fashion.

Email *

Parent/Legal Guardian's Last Name *

Parent/Legal Guardian's First Name *

Relationship to Student *

Mother

Father

Grandparent

Other:

When are you looking to enroll? *

YYYY

Address *

City *

State *

Zip Code *

If not in Florida, are you moving to Florida? If so, when?

(n/a if already in Florida)

Email Address *

Cell Phone Number *

Home Phone Number *

Work Phone Number *

Employer *

Occupation *

Birthday *

YYYY

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