Initial Inquiry Form

Fields marked with an * are required

Parent/Guardian Name *:

Address *:

City *:

State *:

Zip *:

Phone *:

Email *:

Date of Birth:

Grade Applying For:

Proposed Enrollment Date *:

Child's Name *:

Child's Age *:

Child's Current Grade *:

Current/Previous School *:

Child's Medical, Psycho-educational Diagnosis *:

Please give us some background information regarding your child. Why are you looking into a specialty school? *:

How did you hear about us? *: