ES: 775.322.0274   MS: 775.323.2332   HS: 775.829.4601    info@coralacademy.org 

 CAS ENROLLMENT - STEP 1 of 4
 
Enrollment Lottery Process Documentation

  STUDENT INFORMATION:

First Name:*

Middle Name:

Last Name:*

Street Address:

Apt./Suite/etc.:

Country:

City:

State:

Zip Code:
First Name:*

Middle Name:

Last Name:*

Street Address:*

Apt./Suite/etc.:

Country:*

City:*

State:*

Zip Code:*

School 1:

School Name:

School Grade:

School Year:


School 2:

School Name:

School Grade:

School Year:

Is applicant currently under expulsion from any school?*
  No   Yes


Has applicant ever been expelled from any school?*
  No   Yes


Has applicant ever skipped a grade?*
  No   Yes


Has applicant ever repeated a grade?*
  No   Yes


Any fraudulent or untruthful applications and information will void your student application and, subsequently, his/her acceptance into Coral Academy of Science.
I agree to these terms and conditions:*
  No   Yes

Gender:*

Date of Birth:* (MM-DD-YYYY)
- -

Grade Applying for:*
Note: If applying for Kindergarten, student must be 5 years old by September 30th.

School Year Applying for:*

Applicant is the sibling of a current CAS student?*
  No   Yes


Does your child have an IEP?*
  No   Yes


Does your child have a 504 plan?*
  No   Yes


Will you also be submitting another application for a sibling of this applicant?*
  No   Yes

Email:*

Phone:*

Employer Name:

Job Position:

Work Phone:


School 3:

School Name:

School Grade:

School Year:

Please list anything we should know about
your student that will help us better
understand his/her needs:



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