Discover how Crossroads Academy can support your student’s success, start the admissions process today.

ADMISSION INFORMATION

Please fill out the form below. As part of the admissions process, we’ll follow up with you to gather additional details about your student and to schedule a meeting and tour with you. This helps us get to know your family better and ensure we can best support your student’s success. For information about tuition, click here.

After completing the form below, please email the following documents to m.anderson@crossroadsacademyocala.com:

Current IEP or 504 Plan
Most recent report card (including conduct)
Psychological evaluation report (dated within the past 3 years)”**

Student Name

First Name

Last Name

Student Date of Birth

YYYY

Current School

Current Grade Level

Parent or Legal Guardian(s) Name

Best Contact Number

(###)

###

####

Email Address

Does the student have a current 504 or IEP?

If the student is currently at a private school, does he/she have a Private School Service Plan?

What is the student Diagnosed with? Please check all that apply.

ADHD

Anxiety

Dyslexia

Hyperlexia

Dysgraphia

Dyscalculia

Auditory Processing Differences

Other

Does the student have any significant medical history or allergies?

Current Medications

What is the student currently struggling with?

Today's Date

YYYY

Parent Signature

By typing your name here you acknowledge this as an electronic signature.