World Language Academy Application SY2025-26:  SPANISH
LOGAN CITY SCHOOL DISTRICT
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Student Information
Student Last Name *
Student First Name *
Student Date of Birth *
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Does this student currently have an IEP or 504? *
Grade applying for: *
Gender *
Language(s) spoken in the home: *
Student's Primary Language *
Other Primary Language
Does this student have a twin or triplet? *
Does the student have a sibling currently enrolled in the Dual Immersion Program? *
Sibling(s) Name/School
Is there anything else we need to know?
Parent/Guardian Information
Parent/Guardian(s) Name(s): *
Parent/Guardian(s) Street Address: *
City *
State *
Zip Code *
Complete Mailing Address (if different than the street address above):
Parent Phone: *
2nd Parent Phone (if applicable):
Parent Email Address: *
Parent Email Address Confirmation: *
2nd Parent Email Address (if applicable):
2nd Parent Email Address (if applicable) Confirmation:
In which school AND district boundary does your student live in? *
Current school if any: *
Has your child previously attended a full year in an immersion program? *
If yes, please list School / District / State:
If you are not selected, would you like to be placed on the waitlist? *
If I'm not selected for my first choice of language, I wish to be added to both the Spanish and the Portuguese lists. *
Conditions and Consent
I have read and understand the conditions associated with this program.  I understand that this application is not a guarantee of placement in the program.
Parent/Guardian Signature
(Please type your full name as your signature).
 *
Date
(Please type today's date.)
 *
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