Carden Academy

Applying for Grade: *
Select One: Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade 7th Grade 8th Grade

School Year Applying For? *


Student's Full Name: (First, Middle, Last) *


Gender: *
Female
Male

Date of Birth (Month/Day/Year): *


Place of Birth (City/State/Country): *


Primary Residence - Street Address: *


City: *


State: *


Zip Code: *


Telephone Number: *


Last School Attended: *


Primary Language Spoken by Student: *


Other Languages Spoken in the Home: *


Has your student had any educational evaluation? *
Yes
No

If yes, where?


If yes, what kind?


Student is currently living with: *
Select One: Father & Mother Father Mother Guardian

Relationship to Student: *


Parent/Guardian 1 Full Name: (First, Last) *


Parent/Guardian 1 Gender: *
Male
Female

Parent/Guardian 1 Email: *


Parent/Guardian 1 Cell Phone: *


Parent/Guardian 1 Business Phone: *


Parent/Guardian 2 Full Name: (First, Last)


Parent/Guardian 2 Gender:
Male
Female

Parent/Guardian 2 Email:


Parent/Guardian 2 Cell Phone:


Parent/Guardian 2 Business Phone:


Additional Parent(s)/Guardian(s): (include Name, Gender, Email, Phone)


Please list any siblings, their names and ages:


How did you hear about us?