Student's First Name

Student's Last Name

Select one
 Male Female

Age

Applying for
 5th Grade 6th Grade

School Currently Attending

Will student qualify for Free or Reduced Federal Meal Program?
 Yes No

Is student a current or former recipient of the Step Up for Students (formerly PRIDE) scholarship?
 Yes No

Will student qualify for the Step Up for Students scholarship?
For more information on income guidelines, please click here: www.stepupforstudents.org OR www.aaascholarships.org

 Yes No

Guardian Contact Information (mother, father, other)
First and Last Name
 Mother Father Other
Daytime Phone
Evening Phone

Additional Guardian Contact Information (if applicable)
First and Last Name
 Mother Father Other
Daytime Phone
Evening Phone

Mailing Address
Street
City
Zip

Email Address

How did you hear about Academy Prep Center of St. Petersburg?

Please select a date for your student to take the Academy Prep St. Petersburg entrance exam?

*This is our last and final admissions test date for 2017-2018 recruitment

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