Lifted Academy Tour Form

Visit Information

Date of Visit *

Appointment Time

Visit Type

Appointment Walk-In

Student Name *

Gender

Boy Girl

Wants to enroll in Grade *

Date of Birth

Currently in School

Yes No

Name of Current School

Parent Name *

Cell Phone *

Home Phone

Email *

Dates interested in enrolling

What are your expectations for your child?

Schedule of Interest (select all that apply) *

School AgePreschoolVPK

Program Schedule (select all that apply)

8:30 AM – 12:30 PM8:30 AM – 3:00 PM9:00 AM – 12:00 PM6:45 AM – 5:45 PM

Source