The Academy Student Application
Students who are interested in interviewing to attend The Academy will need to complete this application. If selected for an interview the applicant will receive a phone call from The Academy to schedule an interview.

This application is for high school students applying to The Academy. Students in middle school and want to apply to the PASS program need to apply at their home school.

NOTE: Students under the age of 18 will need to be accompanied by a parent or guardian to the interview.
Today's Date *
MM
/
DD
/
YYYY
Last Name *
First Name *
Date of Birth *
MM
/
DD
/
YYYY
Address: Street, Town, ZIP *
Last School Attended *
Other school(s) attended outside of CCPS. Name of school, city, and state where it is located.
Are you ESE or have a 504 plan? *
How many high school credits do you have?
What is your current grade point average (GPA)?
Are you seeking an underage GED waiver? *
Why do you want to attend The Academy? *
Provide two goals you have for this school year? *
What are you interested in doing after high school? *
Are you a pregnant or a teen parent?
Clear selection
Have you ever been arrested and/or charged with a juvenile/adult crime?*Florida Statue 1006.17 requires the disclosure of previous school expulsions, arrests resulting in a charge, and Juvenile Justice actions. Failure to provide accurate information can result in denial of educational participation. *
Arrest Infomation: Date, Charge, and Reason.
Have you ever been suspended or expelled from school? *
Reason for suspension and/or expulsion?
Student Cell Phone Number *
Parent(s) or Guardian(s) Name *
Parent(s) or Guardian(s) Cell Number (Or best number to be reached) *
Submit
Never submit passwords through Google Forms.
This form was created inside of Charlotte County Public Schools. Report Abuse