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Pre K - Grade 3 enrollment Interest Form
Welcome to Samspra Academy !
Enrollment is on a first come first serve basis and is contingent on available classroom space.. To be considered, please complete and submit the Interest Form online.
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* Indicates required question
Email
*
Your email
Name of Parent requesting Info
*
Enter your First and last name
Your answer
Mobile Phone
*
Your answer
Home Address
*
Enter you address - Number, Street, city, state, zip code
Your answer
Student Name
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Current School enrolled
*
Your answer
Last year grade completed
*
Your answer
Is your child eligible for special services (, sp.ed, 504 plan, GT etc)
*
Yes
No
If Yes, Explain
Your answer
Grades interested in
*
Choose
Pre-K 3 Excellence : Ages 3 - 4
Pre-K 4 Excellence : Ages 4 - 5
Kinder Excellence : Ages 5 - 6
Elementary Excellence : Grades 1 - 3
Days
*
Choose how many days per week
Choose
Monday to Friday
3 days / week
2 days / week
Extended Program Needed ?
*
If you need after school care for students, we have 2 choices - till 3.30 pm and 5.30 pm. Choose your preference.
Choose
After school till 3.30 pm
After school till 5.30 pm
No Afterschool, Thanks.
How soon do you want to enroll ?
*
Your answer
Tell Us About the Student
*
Anything you want us to know about your child. (learning needs etc., The school will conduct a 10-15 min of age appropriate learning style assessment during the interview)
Your answer
How did you hear about us ?
*
Your answer
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