POA Application
Application to be enrolled at the Plainfield Opportunity Academy
Email address *
Student Name (First, Last) *
Your answer
Student Cell Phone *
Your answer
Anticipated Start Date at POA *
Grade *
Birthdate *
MM
/
DD
/
YYYY
Mailing Address *
Your answer
Guardian Name *
Your answer
Guardian Cell Phone *
Your answer
Guardian Email Address *
Your answer
If you are accepted into POA, which session would you prefer to attend? *
Explain why you prefer AM or PM Session *
Your answer
Do you have a medical issue that the POA staff should be aware of? If yes, explain. *
Your answer
How would your parents describe your attitude toward school? *
Your answer
What would your teachers say about your effort and behavior in school? *
Your answer
What are your goals or aspirations following high school? *
Your answer
What are your plans if you graduate early at POA? *
Your answer
Have you ever been suspended or expelled from school? If yes, explain. *
Your answer
Do you have PLATO experience? *
Are you currently employed? if yes, state location and supervisor's name/number. *
Your answer
Please use this space to explain why you think POA would be a better fit for your education. This is a very important part of the application. *
Your answer
I have read the POA guidelines and understand the expectations at Plainfield Opportunity Academy. *
POA guidelines:
Submit
Never submit passwords through Google Forms.
This form was created inside of Plainfield Community Schools. Report Abuse - Terms of Service