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* 1. Today's Date

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* 2. Parent Name (First and Last)

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* 3. Parent Phone Number

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* 4. Home Address

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* 5. Parent Email Address

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* 6. Do you currently have students enrolled in the HSA?

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* 7. I am aware that the Home School Academy does not offer a full array of education services, including special education services. The Special Education team will make a determination as to whether the Home School Academy can appropriately meet each child’s needs.

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* 8. Child 1: Information

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* 9. Program selection for Child 1 in 2019-2020?

  1st Choice 2nd Choice 3rd Choice
ARTS K-8th Grade - Monday
ARTS K-8th Grade - Tuesday
STEM K-5th Grade - Wednesday
STEM K-8th Grade - Thursday
STEM K-8th Grade - Friday
TRACKS 6-7-8 Grade - Wednesday
TRACKS 4-5 Grade - Thursday
TRACKS 3 Grade - Friday
High School Expeditions 9-12 Grade - Friday
Concurrent Enrollment 9-12 Grade- various days at PPCC

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* 10. Child 2: Information

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* 11. Program selection for Child 2 in 2019-2020?

  1st Choice 2nd Choice 3rd Choice
ARTS K-8th Grade - Monday
ARTS K-8th Grade - Tuesday
STEM K-5th Grade - Wednesday
STEM K-8th Grade - Thursday
STEM K-8th Grade - Friday
TRACKS 6-7-8 Grade - Wednesday
TRACKS 4-5 Grade - Thursday
TRACKS 3 Grade - Friday
High School Expeditions 9-12 Grade - Friday 
Concurrent Enrollment 9-12 grade- various days at PPCC

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* 12. Child 3: Information

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* 13. Program selection for Child 3 in 2019-2020?

  1st Choice 2nd Choice 3rd Choice
ARTS K-8th Grade - Monday
ARTS K-8th Grade - Tuesday
STEM K-5th Grade - Wednesday
STEM K-8th Grade - Thursday
STEM K-8th Grade - Friday
TRACKS 6-7-8 Grade - Wednesday
TRACKS 4-5 Grade - Thursday
TRACKS 3 Grade - Friday
High School Expeditions 9-12 Grade - Friday
Concurrent Enrollment 9-12 Grade- various days at PPCC

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* 14. Child 4: Information

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* 15. Program selection for Child 4 in 2019-2020?

  1st Choice 2nd Choice 3rd Choice 4th Choice
ARTS K-8th Grade - Monday
ARTS K-8th Grade - Tuesday
STEM K-5th Grade - Wednesday
STEM K-8th Grade - Thursday
STEM K-8th Grade - Friday
TRACKS 6-7-8 Grade - Wednesday
TRACKS 4-5 Grade - Thursday
TRACKS 3 Grade - Friday
High School Expeditions 9-12 Grade - Friday
Concurrent Enrollment 9-12 Grade- various days at PPCC

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* 16. Comment Section:

T