2018-2019 Admissions Application
Please fill out this application in its entirety, so that we may determine your student’s eligibility. Applications with missing information will be excluded from further consideration. CGLA will follow all federal and state laws and constitutional provisions prohibiting discrimination on the basis of disability, race, creed, color, national-origin, religion, ancestry, or need for special education services.
STUDENT INFORMATION
Student's Full Name *
(Last, First Middle)
Your answer
Student's Date of Birth *
MM
/
DD
/
YYYY
Student's Current School *
Your answer
Student's Current Grade *
Required
Student's Full Address *
(Street, City, State & Zip Code)
Your answer
Student lives with: *
(Name & Relationship)
Your answer
PARENT OR GUARDIAN INFORMATION
Parent/Legal Guardian's Name *
(Last, First)
Your answer
Phone Number *
Format (XXX-XXX-XXXX)
Your answer
Parent Email Address *
Your answer
Alternate Contact Name *
(Last, First)
Your answer
Relationship to Student *
Your answer
Alternate Contact's Phone Number *
Format (XXX-XXX-XXXX)
Your answer
ELIGIBILITY DETERMINATION INFORMATION
(At the discretion of CGLA, you may be asked to provide additional documentation to confirm eligibility)
Name of school for which student is zoned for 2018-2019 *
Your answer
Is the student eligible to receive Free or Reduced Lunch? *
Does the student have any siblings currently enrolled at CGLA? *
Sibling's Name(s) & Grade
Your answer
Does the student have any siblings also applying for CGLA? *
(A separate application must be completed for each sibling applying to CGLA)
Sibling's Name(s) & Grade
Your answer
Does the student have any male siblings also applying for Chattanooga Preparatory School?
(A separate application must be completed for each sibling applying to Chatt Prep at www.chattanoogaprep.com)
Sibling's Name(s) & Grade
Your answer
ADDITIONAL INFORMATION
(This information will not be used to determine eligibility)
Does student require Exceptional Education Services (Special Education)? *
Exceptional Education Services required for your daughter will not exclude her from eligibility. If student requires exceptional education services, a copy of the student's IEP/504 Plan MUST be submitted along with the application.
How did you hear about Chattanooga Girls Leadership Academy? *
Please check the appropriate response.
Required
Required Supplemental Documents
Please submit the following items along with the application: • Academic Record (Report Card/Transcript)• Discipline Report • Attendance Record (Can be obtained from student’s current school), IEP/504 Plan (if student receives exceptional education services). Please email them to admissions@cglaonline.com, fax them to 423-386-3005, or drop them off to CGLA's front office between the hours of 8am and 4pm.
To the best of my knowledge, the information given in this application is accurate. I understand that any false information could result in denial of the application.
Name of Parent/Legal Guardian *
Your answer
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