Enrollment Form for 2024/2025
This is the enrollment form for the 2024/2025 School year at LIFE STEM Academy
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Email *
Last Name of Student  *
First Name of Student  *
Middle Name of Student  *
Birthday *
MM
/
DD
/
YYYY
Gender *
Grade *
Which education option are you enrolling in? 
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
Online Payment Option - - https://www.lifestemacademy.com/payment/

Please email amostarfa1@gmail.com if you have any questions
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