Intent to Enroll
at the Ecology Learning Center public charter school, 2020-2021.
Student's First Name *
Your answer
Student's Middle Name
Your answer
Student's Last Name *
Your answer
Student's Date of Birth *
MM
/
DD
/
YYYY
Student's Grade for the 2020-2021 school year (student must be entering grade 9 or 10) *
Required
Student's Primary Mailing Address *
Your answer
Address Line 2
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City *
Your answer
State *
Your answer
Zip Code *
Your answer
Student's Email Address (If none, leave blank; all new Ecology Learning Center students are provided with a school email.)
Your answer
Student's Current School District *
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Current School Name (If your student is homeschooled, write "homeschooled" here.) *
Your answer
Do you have a sibling applying to the Ecology Learning Center? If so, what is their name?
Your answer
Are you the child of an Ecology Learning Center board member, founder, or full-time faculty? If so, who?
Your answer
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