2023-2024 Enrollment Application
Our lottery is closed for the 2023-2024 school year.  Please fill this form out for enrollment interest and as we have space available we will reach out.
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Email *
Family Last Name *
Please use the same last name for all students who share one or more parents/legal guardians and/or mainly live in the same home to aid in grouping siblings.
Parent/ Guardian 1 First and Last Name *
Parent/ Guardian 2 First and Last Name
Student's Physical Street Address *
Student's City/ Zip Code *
Primary Contact Phone # *
Parent/ Guardian 1 Cell Phone *
Parent/ Guardian 2 Cell Phone
Student's First Name *
Student's Last Name *
Student's Gender *
Sibling of currently enrolled student *
Student's DOB *
NOTE: Per federal law Kindergarten students must be 5 years old by September 1, 2023.  At the time of registration, an original birth certificate is required.
Student's Grade for 2023/2024 *
Student's current or former school *
Please tell us how you heard about Village Leadership Academy *
I verify all information provided on this form is true to the best of my ability. I also understand that providing false of incorrect information could jeopardize my child's enrollment should he/she be selected to attend Village Leadership Academy *
A copy of your responses will be emailed to the address you provided.
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