Student Information
First Name of Student*
Last Name of Student*

Student's Date of Birth (xx/xx/xxxx)*
Student's Current School*

Student's Current Grade

Grade Applying for*

Household Information
Father's First Name*

Father's Last Name
Father's Email*

Father's Phone (N/A- Not Applicable is an acceptable response)*

Mother's First Name*

Mother's Last Name
Mother's Email*

Mother's Phone (N/A- Not Applicable is an acceptable response)*

Address*

City*
State*
Zipcode*

How did you learn about TAL Academy*

Please explain why you are considering TAL Academy for your child?*