A.Z. Kelsey Academy Online Application 2024-2025
9th - 12th grades students who reside in Griffin Spalding County Schools who are interested in applying into the Academy Program will complete this online application and follow our application procedures when seeking admission.
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Email *
In addition to submitting this online application, students must select their home base school counselor's email in the drop down box below in order to have the documents listed to be sent to A.Z. Kelsey Academy:
*Most Recent (Previous) and current semester’s attendance report
*Most Recent (Previous) and current semester’s behavioral detail report
*Graduation Academic Progress Report
*Transcript
**Current semester’s grades/Last grade report (only needed if the semester has started and/or grades have not posted to the transcript)

Counselor Selection
In addition to submitting this online application, students must select their home base school counselor's email in the drop down box below in order to have the documents listed to be sent to A.Z. Kelsey Academy (If you are coming from a school out of county then select "out of county" for your response):
Counselor's Email *
Today's Date *
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Student Name (First and Last name) *
Nickname
Home Address *
City *
State *
Home Telephone *
Student Mobile Phone
Student Email *
Sex *
Social Security Number *
Date of Birth *
MM
/
DD
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YYYY
Current School ID
Race/Ethnicity *
Current School that you attend: *
Current Grade Level *
What services do you receive? *
Any other services?
How will you get to school? Please check one. *
Required
FAMILY INFORMATION
Parent/Guardian 1 is the student's primary place of residence
Parent/Guardian 1 Name (First and Last) *
Address *
Relationship to Student *
Workplace *
Occupation/Title *
Parent/Guardian 1 Mobile Telephone *
Parent/Guardian 1 Employer Phone
Parent/Guardian 1 Preferred Email *
Parent/Guardian 2
Parent/Guardian 2 (First and Last Name)
Address
Relationship to Student
Workplace
Occupation/Title
Parent/Guardian 2 Mobile Phone
Parent/Guardian 2 Home Telephone
Parent/Guardian 2 Employer Phone
Parent/Guardian 2 Preferred Email
Emergency Contact
Please list those that can be contacted in a time of emergency when a parent or guardian ca't be reached.
Emergency Contact 1 (First and Last Name) *
Relationship to Student *
Emergency Contact 1 Phone Number *
Emergency Contact 2 (First and Last Name)
Relationship to Student
Emergency Contact 2 Phone Number
Photograph Permission Use: Throughout the school year A.Z. Kelsey Academy students are recognized in various school & community publications. With your signature you are allowing your child's picture to be used a publicized for school purposes only (Parent Signature of first and last name below will give permission if your child is accepted in the program). Place "no" if you do not give permission: *
STUDENT INTENT: Explain in your own words why you want to attend A.Z. Kelsey Academy *
Student Signature: (First and Last Name) *
Parent Signature: (First and Last Name) *
A copy of your responses will be emailed to the address you provided.
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