Imagine Academy of Columbus
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Pre-Enrollment Form
Please note, this is a PRE-enrollment form only. We will contact you with further information. You will need to come in person to our school to officially register your child.
STUDENT INFORMATION
Name
*
Sex
*
Male
Female
Birthday (MM/DD/YYYY)
*
School Year
*
2011-2012
2912-2013
2013-2014
Grade Interested In
*
K
1
2
3
4
5
6
7
8
Current School
*
Does the applicant currently have a sibling or relative attending the school?
*
yes
no
If yes, please list name and relationshiop
*
Do you have additional Siblings you would like to enroll? (If no, skip to parent information)
*
Yes
No
Sibling Name
*
Sex
*
Male
Female
Birthday (MM/DD/YYYY)
*
School Year
*
2011-2012
2012-2013
2013-2014
Grade Interested In
*
K
1
2
3
4
5
6
7
8
Current School
*
Second Sibling Name
*
Sex
*
Option 1
Option 2
Option 3
Birthday (MM/DD/YYYY
*
School Year
*
2011-2012
2012-2013
2013-2014
Grade Interested In
*
K
1
2
3
4
5
6
7
8
Current School
*
PARENT/GUARDIAN CONTACT INFORMATION
Salutation
*
Mrs.
Miss
Ms.
Mother's Name
*
Address 1
*
Address 2
*
City, State, Zip
*
Home Phone
*
Work Phone
*
Cell Phone
*
E-mail Address
*
Salutation
*
Mr.
Father's Name
*
Address 1
*
Address 2
*
City, State, Zip
*
Home Phone
*
Work Phone
*
Cell Phone
*
E-Mail Address
*
Preferred Method of Contact
*
E-mail
Phone
Postal Mail
Person to Contact
*
How did you hear about Imagine Academy of Columbus?
*
If you would like additional information or have other questions or comments, please leave them here
*
Enrollment is on a space-available basis. We will confirm upon receipt of the pre-enrollment form.
Submit