Enroll | Lynwood Academy

Enrollment Application

To apply for enrollment, please fill out the information below.

Student First Name

Student Last Name

Student Birthdate

Gender

Male

Female

Race

Ethnicity

Please List any additional students in your family seeking enrollment (include first name, last name, birthday, gender, grade entering, race and ethnicity)

Parent/Guardian First Name

Parent/Guardian Last Name

Relationship to student

Address

Parent/Guardian Phone

Church

School coming from

Grade Entering

Please describe any medical conditions your student has received treatment for or been diagosed with (i.e. heart trouble, asthma, seizures, diabetes, etc)

Food allergies? Please list all.