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2023-24 Lincoln Alternative Academy Student Application
Students - Please complete this student application to be considered for enrollment at Lincoln Academy. This form should be filled out by the student.
Please understand that filling out this form does not guarantee acceptance into Lincoln Academy.
All responses will be kept confidential and be used as part of the intake / screening process for student enrollment at Lincoln Alternative Academy. Thank you!
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* Indicates required question
Email
*
Your email
Student Last Name
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Your answer
Student First Name
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Your answer
Today's Date
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MM
/
DD
/
YYYY
Date of Birth
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MM
/
DD
/
YYYY
Age?
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Your answer
Grade
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9th
10th
11th
12th
12th and beyond
What is the address of where you are currently living?
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Your answer
Who do you currently live with?
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Your answer
Your Cell Phone Number XXX-XXX-XXXX
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Your answer
If under 18 what is your Parent / Guardian Last Name
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Your answer
If under 18 what is your Parent / Guardian First Name
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Your answer
If under 18 what is your Parent / Guardian Cell Phone #...XXX-XXX-XXXX
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Your answer
Are you currently enrolled in school?
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Yes
No
If you answered yes, what is the name of the school you are currently enrolled?
Your answer
If you answered no, what is the name of the school where you last attended? And what month and year did you exit that school? (Example: Cushing High School, May 2022)
Your answer
About how many days of school did you miss last year?
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Less than 10
Less than 20
More than 20
Why were you absent from school?
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Your answer
Are you currently suspended from school?
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Yes
No
If you are currently suspended, what are the reasons for suspension and for how long are you suspended?
Your answer
Have you ever been placed in In-School Suspension or Out-of-School Suspension?
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Yes
No
If you answered yes, list the reasons and the length of your suspension.
Your answer
How did you hear about Lincoln Academy?
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SHS or SJHS Counselor Referred me for Enrollment
My Teacher or Principal
A Friend
I have family members who have attended Lincoln Academy
I am new to town and heard about Lincoln Academy
Other:
If you marked family members please list their names.
Your answer
Do you know any students who attend Lincoln Academy? If so, please list their names.
*
Your answer
Are you currently involved in the court system?
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Yes
No
If you answered yes to being involved in the court system, please share information as to your involvement (ex. truancy court, etc.)
Your answer
Have you ever received special services for being on an Individualized Education Plan (IEP)?
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Yes
No
If you answered yes to being on an IEP, what areas of support did you receive (Math, Reading, Behavior, etc.)?
Your answer
Have you ever received special services for being on a 504 or Health Plan?
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Yes
No
If you answered yes to being on a 504 or Health Plan, why were you placed on one?
Your answer
Please share with us your plan for how you will find success here with us at Lincoln.
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Your answer
What are your plans after high school?
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Your answer
Please share with us why you would like to attend Lincoln Academy? If there's something we did not ask and you would like for us to know, please feel free to share. (3 to 5 Sentences).
Your answer
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