2018-19 Online Application
Interested in enrolling at Coastal Leadership Academy, the public choice high school in Horry County? Please complete the following form. Hard copies may be picked up from school as well.
Email address *
Student Name *
Your answer
Grade Level 2018-19 *
School previously attended *
Your answer
Please name the base high school your child is zoned to attend (for transcript purposes): *
Your answer
Date of birth *
MM
/
DD
/
YYYY
Have you toured Coastal Leadership Academy? *
District of Residence (Horry, Georgetown, etc.) *
Your answer
Parent First and Last Name *
Your answer
Parent E-mail *
Your answer
Parent's Primary Phone Number *
Your answer
Parent's Alternate Phone Number *
Your answer
Address (street number and name, city, state, zip code) *
Your answer
How did you hear about us (please check all that apply)? *
Required
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Coastal Leadership Academy.