Excel Academy Interest Form
Excel Academy does not discriminate on the basis of race, color, religion, national origin, or sexual orientation with respect to the admission of students and hiring of employees.  All students are admitted through an open enrollment process – there are no admissions tests or fees.  We are a FREE public charter school and do not charge tuition.
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Student Last Name *
Student First Name *
Date of Birth *
MM/DD/YYYY (ex. 01/09/1994)
2013-14 Grade Level *
Current Grade Level
2013-14 Grade Level *
Anticipated Grade Level
Current School (If Applicable) *
Address *
City *
Required
State *
Required
Zip Code *
Ward *
Parent/Guardian Name *
Additional Parent/Guardian Name
Parent/Guardian Day Phone *
555-555-5555
Parent/Guardian Evening Phone
555-555-5555
Parent/Guardian Email
Are there currently any siblings attending Excel Academy OR siblings that will also apply for admission in 2012-13? *
Please list the attending or enrolling student name(s).
How did you hear about Excel Academy?
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