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Online Application

Student Application for
Esperanza Academy K – 12th

    Grade Applying:*

    School Year:* You must select the school year that you are applying for.

    Please note the grades we offer each year:
    2024-2025: Grades K-3 and 6-12
    2025-2026: Grades K-12

    Student’s Full Name:

    Last Name:*

    First Name:*

    Middle Initial:

    Mailing Address:

    Street:*

    City or Town:*

    State:*

    Zip Code:*

    Date of Birth:*

    Current Grade:

    Current School:

    Current Esperanza Academy Sibling Information:

    Sibling 1 - Last Name:

    Sibling 1 - First Name:

    Sibling 1 - Current Grade:

    Sibling 2 - Last Name:

    Sibling 2 - First Name:

    Sibling 2 - Current Grade:

    PARENTS/GUARDIANS INFORMATION

    Parent/Guardian’s Full Name:

    Last Name:*

    First Name:*

    Middle Initial:

    Mailing Address (If different than students):

    Street:

    City or Town:

    State:

    Zip Code:

    Cell Number:

    Work Phone Number:

    Home Phone Number:

    Email Address:*

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