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OLA Initial Enrollment Form
Part 1 - Student Information
*
Indicates required field
Student LAST Name
*
Student FIRST Name
*
Student MIDDLE Name or Initial
*
Student Date of Birth
*
Student Gender
*
Female
Male
Other
Grade Level in Which Student Will Enter OLA
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4
5
6
7
8
9
10
11
12
Part 2 - Parent Information
Parent/Guardian 1 (First Name)
*
Parent/Guardian 1 (Last Name)
*
Parent 1 Email
*
Parent 1 Cell Phone Number
*
Parent/Guardian 2 (First Name)
*
Parent/Guardian 2 (Last Name)
*
Parent/Guardian 2 Email
*
Parent 2 Cell Phone Number
*
Home Phone Number
*
Physcial Address For Packages and Residency Verification
*
Line 1
Line 2
City
State
Zip Code
Country
Postal Mailing Address (If different from physical address)
*
Line 1
Line 2
City
State
Zip Code
Country
Part 3 - Student Background
List Prior Schools Attended, Most Recent First
School 1 Name
*
School 2 Name
*
School 1 City & State
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School 2 City and State
*
Attended (mm/yyyy to mm/yyyy)
*
Attended (mm/yyyy to mm/yyyy)
*
Student Plans (Please check one)
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IEP
504
None
How did you learn about OLA (Check all that apply)
*
I heard about OLA from families with students enrolled inOLA
Internet Search
CDE's Website
Other (list below)
Other
*
Submit
