Parent(s) Name

Phone Number

Email Address

1. Student's Name

1. Student's Date of Birth

2. Student's Name

2. Student's Date of Birth

3. Student's Name

3. Student's Date of Birth

4. Student's Name

4. Student's Date of Birth

Are you interested in 2 Day (Tuesday & Thursday) or a 4 Day (Monday-Thursday) schedule? Are you interested in 2 Day (Tuesday & Thursday) or a 4 Day (Monday-Thursday) schedule? 2 Day (Tuesday & Thursday) 4 Day (Monday-Thursday)

Teacher Reference/Phone Number from previous school year:

Previous Schools Attended

Tell us about you and your family. (Hobbies, interests, religious activities, etc.)

Why are you interested in joining LEAD Academy?

For student success, it is crucial that parents be involved in their students education. In what ways are you involved in the discipleship and education of your student? How will you assist your student in being a successful student at LEAD Academy?

Most challenges we encounter are from unmet expectations. Please help us understand your expectations of LEAD Academy.

LEAD Academy often needs volunteers for special events. What strengths do you offer to help serve at Lead Academy? (Check all that apply) LEAD Academy often needs volunteers for special events. What strengths do you offer to help serve at Lead Academy? (Check all that apply) Praying Teaching Financial Support Encouragement Administration Hospitality Other