Interest Form

If you are ready to proceed and want to be placed on our lottery list please complete this interest form. Please ensure that the email provided is correct as that is how we will notify you that we have received this information. If you are undecided and still have questions please call the office (386-586-0100); we’ll be more than happy to get your questions answered.

Next school year 2021-2022: The lottery drawing will be held on March 26, 2021

Prospective Student Application

Step 1 of 4

25%

Parent/Guardians Name*
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
County
Phone
Daytime Phone Number
Cell Phone
Cell Phone Number
Email*

Personal Email Address
How did you hear about us?

Prospective Student Information, please complete a fully as possible.
Prospective Students Name*
First Last
Students Gender*
Birthdate*
Grade Interest In*
School Year of interest*
Name of Current School, if applicable.
Is a sibling of the applicant currently attending this school?*
- No
- Yes
Currently Enrolled Siblings Name*
First Last

Will another sibling be pre-enrolling as well?*
- No
- Yes
Prospective siblings information, please complete the following fields below.
Prospective Siblings Name*
First Last
Prospective Siblings Gender*
Prospective Siblings Birthdate*
Prospective Siblings Grade of Interest*
Prospective Siblings School Year of interest*
Name Prospective Siblings Current School, if applicable.

Additional Information
Any additional information you would like to share with us or questions you may have about Imagine Schools.
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