Kaleidoscope Academy

ENROLLMENT APPLICATION FOR 2012-2013

STUDENT APPLICANT NAME
DATE OF BIRTH GRADE FOR 2012-2013
PARENT(S) OR GUARDIAN(S)
ADDRESS
CITY ZIP
PHONE: HOME ()
WORK () CELL ()
NAME(S) OF OTHER APPLICANTS FROM THIS FAMILY

***IF YOU LIVE OUTSIDE OF THE AASD SCHOOL DISTRICT, call 832-6116 for open enrollment information.***

EMAIL ADDRESS
Do you reside in the Appleton Area School District?

If yes, what is your neighborhood school?
If no, current school district & school?

Does your child receive special education and/or ELL services? If yes, does the child have an Individualized Education Program (IEP) If yes, what ELL level is your child?

Parent/Guardian Signature (Type for Online Form)

Applications must be returned between December 1, 2011 and February 24, 2012 to: Kaleidoscope Academy, 318 E. Brewster Street, Appleton, WI 54911

You will be notified of enrollment status via postal mail by: March 15, 2012

Please contact us at (920) 832-6294 or by with any questions.

The Appleton Area School District does not discriminate against pupils on the basis of sex, race, religion, national origin, ancestry, creed, pregnancy, marital or parental status, sexual orientation or physical, mental, emotional, or learning disability or handicap in its education program or activities.