Valrico Lake Academy

2014 - 2015 Student Online Application

Please select the grade that your child will be entering in August 2014 

Student Information:

Student First Name       Student Middle Name        Student Last Name  

Student School ID Number         Please Choose One             

Students Date of Birth      mm/dd/yyyy                 Language spoken in the home: 

School Currently Attending      If this will be the first school student attends leave as "N/A".

 

Parent/Legal Guardian Information:

Parent First Name       Parent Middle Name        Parent Last Name  

Parent Mailing Address: 

Parent City     Parent State     Parent Zip Code

Parent Home Phone     Parent Work Phone     Parent Cell Phone

Parent Email Address

Is a parent currently active in the Military? 

 

Sibling Information:

If a sibling of this student is currently attending the school please provide us with the Name of the student, grade of the student and date of birth of the student below:

Sibling Attending Name     Sibling Attending Grade     Sibling Attending Date of Birth      mm/dd/yyyy

 

Will a sibling of this applicant be applying to this school for the 2014 - 2015 school year? 

If yes, please indicate the name and grade level for 2014-2015 below:

Please note:  A separate application must be completed for each student wishing to attend the school August 2014.

If yes, please indicate the name and grade level of the sibling/siblings

Sibling Name     Sibling Grade     Sibling Date of Birth      mm/dd/yyyy

Sibling Name     Sibling Grade     Sibling Date of Birth      mm/dd/yyyy

Sibling Name     Sibling Grade     Sibling Date of Birth      mm/dd/yyyy

 

 

To the best of my knowledge, the above information is accurate and complete.  In the event of a change of address, phone number, name, etc.: I will notify the school.

Thank you for completing this online application for your child to attend the Valrico Lake Academy during the 2014 - 2015 school year.  You will receive an email confirmation after you click the Submit button below.