Cole Academy

Registration Form

Cole Academy
1915 W. Mt. Hope
Lansing, Michigan 48910
(517) 372-0038
Fax: (517)372-1446
info@coleacademy.org

Child Info
First:
Middle:
Last:
	Boy Girl
Birth date: dd/mm/yyyy
Age on enrollment:	Years Months
Mother/Guardian Info
Name:
Place of Business:
Work Phone:
Cell Phone:
Father/Guardian Info
Name:
Place of Business:
Work Phone:
Cell Phone:
Home Address of Child:
Street:
City:
Zip:
Home Phone:
Adult(s) who have main responsibility for child:
Last Grade Child Completed:
Child's allergies:
Where did you learn about Cole Academy?
Parent Guardian expectations for child at Cole Academy:
We(I) understand that applications for Cole Academy will be accepted during an advertised registration period. Applications received before this period for the next school year will be considered at that time. If applications received during this period exceed the number of vacancies a lottery will be held for available slots. We(I) understand that after this open enrollment period applications will be accepted on a first come first serve basis for any vacancies that are available.
By submitting this form, you agree to the above statement.