Enrollment Form for 2023/24
This is the enrollment form for the 2023/2024 School year at LIFE STEM Academy
Sign in to Google to save your progress. Learn more
Email *
Full Name of Student  *
Birthday *
MM
/
DD
/
YYYY
Gender *
Grade *
Which education option are you enrolling in? Students can do the Hybrid Option (Mondays/Thursdays) or the Full time option (Mondays-Fridays)
Clear selection
Home address *
City *
Zip Code *
State *
Cell Phone of Parent *
Home Phone
Email of student/email parents will use for the student *
Emergency Contact Name *
Cell Phone of Emergency Contact
Emergency Contact's Relationship to student *
Any allergies (peanuts, gluten...) *
Please will you like to pay your tuition online or with a check?
Please how will you like to pay your tuition?
Clear selection
What courses will the student be taking? *
Required
Our students get access to our Teachable site with our Math Courses and other online courses which they can use on Tuesdays, Wednesdays and Fridays (Please create an account for each student) - https://learn.fulllifeacademy.org/p/life-stem-academy
Please indicate what sports the student is interested in playing - 
Online Payment Option - - https://www.lifestemacademy.com/payment/

Please email amostarfa1@gmail.com if you have any questions
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms