2021-2022 :: Level Up Academy: Apply Online

Level Up Academy Online Enrollment for 2021-2022

Child's First Name Required

Child's Middle Name Required

Child's Last Name Required

Grade Applying For Required

We are applying for the following learning platform: Required

Child's Home Address

Address 1

Address 2

City

State/Province

Country

Postal Code

Primary Family Email Required

Guardian #1 First Name Required

Guardian #1 Last Name Required

Guardian #1 Daytime Phone Required

Guardian #2 First Name

Guardian #2 Last Name

Guardian #2 Daytime Phone

Does this student have a sibling already enrolled or applying for Level Up Academy? Required

If Yes, Sibling's Full Name

Full Name of Person Submitting This Form Required

Relationship To Student Required