Online Application Form for New Students - Part One

2012-2013 McKinney Academy Application - Part One (New Students Only)

First Name

Last Name

Full Mailing Address including zip code

Primary Contact Phone Number

Primary Contact Phone Number :: Numbers Only, No spaces no parentheses

First Name

Last Name

Student Gender

Birth Date

Birth Date :: mm/dd/yyyy

Grade Level

Name(s) and age(s) of other students in the family who have attended or are attending McKinney Care and/or McKinney Academy:

Please tell us how you heard about McKinney Academy

If you heard of McKinney Academy from a newspaper media, please list all that apply

Charlotte Observer
Herald Weekly
Lake Norman Citizen
Lake Norman Magazine

If you heard of McKinney Academy from a newspaper media, please list all that apply :: Choose all that apply

If a friend referred you, please provide the name of your friend

Please enter the characters in the image.