Performance Learning Center Application 2025-2026

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Performance Learning Center Application 2025-2026

Student's First name? *

Student's Last name ? *

Street Address *

City *

State *

Zip Code *

Student's cell phone number? *

Student's email address? *

Student's date of birth? *

YYYY

Student's age? *

Student's ethnicity? *

African American

Hispanic

Multi Racial

Caucasian

Asian

Other:

Name of Parent/Guardian 1 ? *

Guardian 1 phone number? *

Guardian 1 email address? *

Name of Parent/Guardian 2 ?

Guardian 2 phone number?

Guardian 2 email address?

Have you ever applied to the Performance Learning Center before? *

Yes

Current school or last school attended? *

Central Cabarrus

Concord High

Cox Mill

Hickory Ridge

Jay M Robinson

Mount Pleasant

Northwest Cabarrus

West Cabarrus

Cabarrus Early College

Early College of Technology

Opportunity School

Homeschool

Other:

Last grade completed? *

How many credits have you earned towards graduation? *

Is applicant/student pregnant or parenting? *

Yes

Does student/applicant receive any the following services at current school? *

504

ELL

IEP

Required

What are your academic strengths? *

What are your academic weaknesses? *

Does student/applicant currently work? *

Yes Full time

Yes Part time

Other:

Why are you interested in attending the PLC?

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