2025-2026 Student Interest Application

By filling out the Intrest Form you are acknowledging that your student has a Medical Diagnosis or Educational IEP of Autism Exceptionalities. Once the Intrest Form is completed and submitted you will need to bring a copy of the following documents to the school. (1) Birth Certificate (2) Social Security Card (3) Immunization/Shot Record (4) Copy of parent/guardian's Photo ID (5) Two proof of residence- ex. gas, water, electric bill or lease and (6) Medical Diagnosis or IEP. Once all required documentation is collected the application will be reviewed and the leadership team will contact you to schedule an appointment for program screening. This does not guarantee your child has been accepted.

*Available spots are determined by the number of returning students

Students First Name*

Answer Required

Students Last Name*

Answer Required

Grade Entering 2025-26*

Answer Required

School that your child is currently attending*

Answer Required

Students Date of Birth*

Answer Required

Gender*

Answer Required

Male

Female

Race*

Answer Required

American Indian or Alaska Native

Asian

Black or African American

Native Hawaiian or Pacific Islander

White

Other:

Parish in which you live*

Answer Required

Does your child qualify for Free and Reduced Lunch?*

Answer Required

Yes

Contact Information

Parent First Name*

Answer Required

Parent Last Name*

Answer Required

Parent Email*

Answer Required

Parent Cell Phone*

Number Required

Please fix the highlighted areas below before submitting.

2025-2026 Student Interest Application