Student Application – Elevation Community School

Step 1 of 5

Student Information

There is a $50 application fee applied per child (non-refundable). You will be able to add siblings later in the form.

Student's Name(Required)

First Last

Child's Gender(Required)

Male

Female

Child's Grade for the 2023-2024 School Year(Required)

Date of Birth(Required)

Birth Place (State, Country)(Required)

Language Used at Home(Required)

Academic Information

Has the student ever received Special Education?(Required)

Yes

Has the student ever been expelled?(Required)

Yes

Has student received additional help in reading or math?(Required)

Yes

Please provide details of struggles the student has had in their previous learning environment (if applicable):

Last School Attended (homeschool, school name)(Required)

Medical Information

Does this student have any allergies? If yes, please list them below, otherwise leave blank.

Does this student have medical concerns that the school should be aware of? If yes, list them below, otherwise leave blank.

Parent Information

Father's Name and Last Name(Required)

First Last

Father's Occupation(Required)

Father's Work Hours (ex. 9am-5pm)(Required)

Father's Email(Required)

Father's Phone(Required)

Family Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Mother's Name and Last Name(Required)

First Last

Mother's Occupation(Required)

Mother's Work Hours (ex. 9am-5pm)(Required)

Mother's Email(Required)

Mother's Phone(Required)

Who does the child live with? (ex. mom and dad, grandma, etc)(Required)

Filling Out the Student Application Ensures Your Spot for the Family Interview

* Due to the high demand of this program, we encourage you to secure your family’s spot before the application cap gets filled *

Application Overview

Student Information

Academic Information

Medical Information

Parent Information

Emergency Contact Information

Sibling Information

Academic Information

Medical Information

Academic Information

Medical Information