Learning Communities Student Application
Please complete the form below to participate in a Learning Community. Applications are accepted until Friday, August 18, 2017. The first day of class is Monday, August 21, 2017. Upon completion of this application, parents will be contacted to schedule an interview with the student and at least one parent. Acceptance is based on both the application and the interview. Learning Communities are a service of Family Forum LLC.
Student Applicant First Name
Please enter the student's first name.
Your answer
Student Applicant Last Name
Please enter the student's last name.
Your answer
Student Applicant Email Address
Please enter the student's email address.
Your answer
Student Applicant Birth Date
Please enter the student's birth date. 2017-2018 Learning Communities are open to students born on or before August 31, 2005
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/
DD
/
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Student Gender
Student Level
Please select the student's level for the 2017-2018 school year.
Time Zone
Please select the time zone in which the student resides:
Parent 1 First Name
Please enter parent 1's first name.
Your answer
Parent 1 Last Name
Please enter parent 1's last name.
Your answer
Parent 1 Email Address
Please enter parent 1's email address.
Your answer
Parent 1 Phone Number
Please enter parent 1's phone number.
Your answer
Parent 1 Physical Mailing Address
Please enter parent 1's physical mailing address.
Your answer
Parent 2 First Name
Please enter parent 2's first name
Your answer
Parent 2 Last Name
Please enter parent 2's last name.
Your answer
Parent 2 Physical Mailing Address
Please enter parent 2's physical mailing address, or indicate "same" if it is the same as parent 1.
Your answer
STUDENT Essay: Why do you want to be a part of a Learning Community?
Please write 100–150 words.
Your answer
PARENT Essay: Why do you want your child to be a Learning Community?
Please write 100–150 words.
Your answer
Student Webinar Participation Agreement
As a member of a Learning Community, I understand and agree to the following participation conditions (please check all boxes below):
Required
Student Course Participation Agreement
As a Learning Community applicant, I understand and agree to the following participation conditions (please check all boxes below):
Required
Student Honor Code Agreement
As a Learning Communities applicant, I understand and agree to the following student honor code agreement:
Required
Student Release Agreement
I understand and agree to the following conditions and agreements for participation:
Required
Parent Release Agreement
I understand and agree to the following conditions and agreements for participation:
Required
Information Release for Learning Community Directory (Optional)
I understand and agree to the following optional agreement:
Required
Parent Finance Agreement
I understand and agree to the following conditions and agreements for participation (Check all boxes):
Required
Privacy Policy
Please read and agree to our privacy policy. Please indicate your agreement by checking the box below.
Required
Parents: How can we best serve your education needs?
Parents: Please let us know about any considerations that you'd like our teachers and administrators to be aware of in serving the educational needs of your student.
Your answer
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