Pratt Academy Student Application Form

1.	Applying to enroll for:*
	Applying to enroll for:* 2020-2021 school year 2021-2022 school year

2.	Student Name: * (all text boxes expand to accommodate answers)

3.	Name of person completing application and relationship to student* (Choose "self" if student completing application) Select at least 0 and no more than 0.
	Self    Other, please specify name/relationship to student

4.	Mailing Address* (Please provide a physical address where student can receive mail)
	Street/P.O. Box   City   State   Zip

5.	Date of birth*
	mm/dd/yyyy

6.	Current school district: *
	Spokane Public Schools    Other, please specify

7.	If a Spokane Public School student, Student ID number:

8.	Name of last high school attended:*

9.	Current Grade:* (If enrolling in summer, list grade student is entering)
	--Please Select--910111212+

10.	Name of last high school counselor:

11.	Student email:

12.	Student Phone:*
	Home   Cell

13.	Parent/Guardian Name: * If not applicable, put "N/A" and a brief explanation.

14.	Parent/Guardian Email:

15.	Parent/Guardian Phone:

16.	Student has parent/guardian approval for application and transition to Pratt Academy*
	--Please Select--YesNoN/A

17.	Does student have a health plan on file?*
	Does student have a health plan on file?* YesNo

18.	If answer to question #16 is "yes," is the health condition life threatening?
	If answer to question #16 is "yes," is the health condition life threatening? YesNo

19.	Does student have a 504 plan? *
	Does student have a 504 plan? * YesNo

20.	If student has 504 plan, please describe.

21.	Does student receive Special Education services? *
	Does student receive Special Education services? * YesNo

22.	Credits Earned: *  (99) Enter how many credits student has earned to this date. The value must be between 0 and 26, inclusive.

23.	State Testing Scores* Enter applicable scores from the following WA state standardized tests. Enter NS for no score. Enter the STATE NAME if you took a standardized test in another state.
	ELA SBAC   Algebra EOC   Geometry EOC   Math SBAC   Biology EOC

24.	Has student taken the SAT, PSAT, ACT or ITED?* Select at least 0 and no more than 0.
	No    SAT    PSAT    ACT    ITED    Scores (include both total score and any individual sub-scores)