This Preregistration form is for New Students only.

Reenrollment for current students will be open February 1st, 2018.


Student Information
Legal Name from Birth Certificate
**First Name: Middle: **Last:
**Date of Birth: mm/dd/yyyy
**Gender:
Preferred First Name:
**School:
**Previous School:
Enter NONE in all three boxes
if Kindergarten student
School Name:
City:
State:
**Next Year's Grade Level:
**Anticipated Start Date:
Current Special Programs IEP 504 ELL Speech Therapy
**Attended before Has this student ever attended American Leadership Academy before?
**Applied before Has this student ever applied to American Leadership Academy before?
**Spanish Dual Immersion Are you interested in the Spanish Dual Immersion program for grades 1-6 only?
**Spanish Dual Immersion Have you attended a Spanish Dual Immersion program before?
**Kindergarten Is this student registering for full-time or half-time kindergarten?
**Accelerated Learning Program Are you interested in the Accelerated Learning Program for grades K-2 only?
**Multiple Family Members
**ALA Employee Does the parent or guardian of this student work for American Leadership Academy?
Employee Name If Yes above, please enter the employee name.
Guardian Information
**First Name: **Last Name:
**Relationship to Student:
Other Students in Family: Check this box if other members of your family are active students at our schools
**Desired User Name: Desired User Name for PowerSchool Login
**Email:
**Phone: 999-999-9999      Alternate Phone: 999-999-9999
**Street:
**City:
**State:
**Zip Code:
**Verification: I verify that the above information is correct
** Required Information