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APPLICATION FORM
Achievement Prep is currently accepting applications for 4th and 5th grades for the 2008-09 school year.

Please provide the following information:                                                                                                                                    

STUDENT INFORMATION
Full Name Male or Female Date of Birth
Current School Current Grade Grade for 2008-09
Street Address Home Phone
City State Zip Code
      
PARENT/GUARDIAN INFORMATION

Mother/Guardian Name

Lives with child?

Work Number

Cell Number

E-mail

Father/Guardian Name

Lives with child?

Work Number Cell Number E-mail

Please indicate whether the applicant's sibling is applying to Achievement Prep for Fall of 2008. Please note that each child needs to submit a separate application.

Name

Age

Current Grade Applying for Fall '08

Name

Age

Current Grade

Applying for Fall '08

How did you learn about Achievement Preparatory Academy?

Internet

Flyer

Received Mailing Newspaper:

Friend/Family

Other:

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applications@aprepacademy.org
Non-discrimination Policy