2018-2019 Brevard Academy Lottery Application
By filling out this form, your child will be placed on our current waitlist or be included in our lottery if we are in our Open Enrollment period (January 14 - March 15). If your child is offered a spot at Brevard Academy: A Challenge Foundation Academy, you will need to accept the spot and complete a full enrollment packet.
Email address *
Student Last Name *
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Student First Name *
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Student Middle Name *
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Student Grade Level *
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Student Home Address (please include city, state and zip code) *
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Parent/Guardian Email *
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Parent/Guardian Mailing Address (please include city, state and zip code) *
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Parent/Guardian Phone Number *
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Is this student a child of a current Brevard Academy Staff member? *
Is this student a sibling of a current Brevard Academy student? *
Is this student a sibling of a current Brevard Academy student? *
Parent/Guardian Signature (by inserting your name here you affirm that all information provided herein is correct and complete.) *
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