Triad Math and Science Academy Application For 2010-2011 School Year

Thank you for considering Triad Math and Science Academy (TMSA) for your child's education. Your application will be entered into our 2010-2011 school year application pool. The email address to be entered below will be used for correspondence between you and TMSA for all school announcements and registration details and updates.
Student Information
Student's First Name:
Student's Last Name:
Student's Date of Birth :
- - *month-day-year
Your Name:
Area Code & Phone Number:
- -
Your Relationship to Applicant:
Home Address:
City:
Zip:
Parent's Email:
Applicant Demographic Information
Curent School:
Applying For Grade :
K
1
2
3
4
5
6
7
8
9
Has applicant ever skipped grade?:
 Yes   
No
If Yes, what grade
Is the applicant currently under expulsion?:
 Yes   
No
If yes, please explain
Gender:
Male   
Female
   
Race
Asian 
Caucasian
African-American
 
Hispanic
Multi-racial 
Other
 
Has the student received services in the following programs?
ESL:
Yes   
No
If Yes, Language
Exceptional Children:
Yes   
No
If Yes, area
Advanced Learner:
Yes   
No
If Yes, Subject
How did you hear about Triad Math and Science Academy?:
*Media, Brochure, Friends, Web Site, Other
I hereby certify that, to the best of my knowledge and belief, the answers to the foregoing questions and statements made by me in this application are complete and accurate. I understand that any false information, omissions, or misrepresentations of facts may result in rejection of this application or future dismissal of the applicant. I also understand that Triad Math and Science Academy will contact me for future communication.
I accept terms and conditions explained above