Discovery Learning Academy

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Discovery Learning Academy - New Submission

Welcome to Discovery Learning Academy!

We are so excited that you are interested in joining our family! Space is very limited, so please completely fill out the information requested below.

If you have immediate questions and/or would like to schedule a tour, please contact us at 240-814-9923.

..................................

Bienvenidos a Discovery Learning Academy!

Nos emociona mucho que estén interesados en unirse a nuestra familia! El cupo es muy limitado, así que por favor completen la información solicitada a continuación.

Si tienen preguntas urgentes o desean programar una visita, contáctenos al 240-814-9923.

Parent/Guardian Name

Nombre del padre/tutor

Parent/Guardian Contact Number

Número de contacto de padre/tutor

Parent/Guardian Email Address

correo electrónico de padre/tutor

Student Name

Nombre de estudiante

Student Age

Edad de estudiante

Student DOB (MM/DD/YYYY)

Fecha de nacimiento de estudiante (MM/DD/AAAA)

Desired Location

Ubicación deseada

202 Riggs Rd. NE, Washington, DC 20011

356 Eastern Ave. NE, Washington, DC 20019

2201 Shannon Pl SE, Washington, DC 20020

444 16th St. NE Washington DC 20002 (COMING SOON!)

Required

Desired Start Date

Fecha de inicio deseada

Will you be applying for a Subsidy voucher?

Vas a solicitar un vale de subsidio?

Yes, I would like you to help me with applying for an in house voucher. (Sí, me gustaría que me ayudaran a solicitar un vale interno.)

Yes, I plan on receiving a voucher through DHS/ A case worker. (Sí, planeo recibir un vale a través del DHS/un trabajador social.)

No, I will be paying through private pay (No, pagaré mediante pago privado.)

Other:

Additional Comments

Comentarios adicionales

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Discovery Learning Academy.

Does this form look suspicious? Report

Forms