School Year 2024-2025 Application Form

Thank you for your interest in our programs. Please fill out one form per child.

1st Parent/Guardian Full Name

2nd Parent/Guardian Full Name

Home Address

Email

Phone

Learner's Full Name

Learner's Date of Birth

Learner's Identified Gender

Female Male Other Prefer not to answer

What program (s) are you applying to?

2024-2025 Learning Pods K-12 Tutoring Enrichments Other

What grade level would your child be in upon enrollment?

Please choose your schedule:

2 Day 3 Day 5 Day Full Time

Other:

Does your child have any allergies?

What are the top 3 things that you would like your child to explore?

Which subject does your child work at with little effort?

Out on the playground what would your child be doing?

Does your learner have any disabilites/504 plan/or an IEP?

Does your learner have Step-Up for Students Scholarship?

FTC-PEP FES-UA None

Is there anything else you would like us to know?

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Email

Email

Address: 11442 W Sample Rd, Coral Springs, Florida 33065 | Phone: 786-368-8979 | Email: hello@PLAYschoolacademy.com

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