Peak Potential Academy Application — Parent

Applicant Name

First Name

Last Name

Applicant Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Applicant Email

Applicant Phone

(###)

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Grade Level Fall 2023

Parent/Guardian 1 Name

First Name

Last Name

Parent/Guardian 1 Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Parent/Guardian 1 Email

Parent/Guardian 1 Phone

(###)

###

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Parent/Guardian 2 Name

First Name

Last Name

Parent/Guardian 2 Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Parent/Guardian 2 Email

Parent/Guardian 2 Phone

(###)

###

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Siblings

Name, grade and what is their plan of study 2021-22?

Has the applicant ever received disciplinary action at school?

Applicant Details

What is your student's learning style, strengths and weaknesses.

What would you like us to know about your child?

Do you have questions for us?

Learning Accommodations

Does the student have an IEP? If yes, please describe briefly.