Home School Registration
Academy Charter School Registration
Homeschool Support Program
Email address *
Parents first and last name *
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Street Address *
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Address Line 2
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City *
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State *
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Zip Code *
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Home Phone
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Cell Phone *
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Best Number to reach you during school hours *
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Emergency Contact Name *
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Emergency Contact Phone *
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Child's Full Name (first, middle, last) *
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Male or Female *
Grade Entering this School Year 2018/19 *
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Date of Birth *
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Registering as a part-time student at Academy Charter School for the home school classes conducted in *
Enrolled in any other public funded program? *
Please list any health concerns, learning plans, or other issues
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Questions or comments
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A copy of your responses will be emailed to the address you provided.
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