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Learning Loft Enrollment Request Form
General waiting list request form for Baum Blvd, Catalyst Academy, Urban Academy, Penn Hills Charter School for Entrepreneurship
and Hill District locations
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* Indicates required question
Email
*
Your email
Physical Mailing Address
*
Your answer
Location Of Interest
*
Learning Loft at Urban Academy
Learning Loft Hill District
Learning Loft at Catalyst Academy
Learning Loft on Baum
Learning Loft at PHCSE (opening Fall 2023)
Required
Program(s) of Interest
*
Infant program (Hill District or Baum)
Toddler Program (Hill District or Baum only)
PreK 3 Program (Hill District, Baum or PHCSE)
PreK 4 Program (Hill District, Baum or PHCSE)
Extended Day Program (All)
Summer Camp (Hill District, Baum, or PHCSE)
Required
Child(ren)s Name(s)
*
Your answer
Child's Date of Birth
*
MM
/
DD
/
YYYY
Child's Date of Birth
MM
/
DD
/
YYYY
If an extended day request, please select grade(s)
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
Parent or Guardian Name
*
Your answer
Phone Number
*
Your answer
Notes? (Include any additional siblings here)
Your answer
A copy of your responses will be emailed to the address you provided.
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