Registration

We appreciate your interest in My Dreams Academy. Please complete this application form, and a representative from our Admissions Office will contact you to discuss the next steps in the application process. You must email your records of vaccines, transcripts, and photo ID; these are needed to create your academic profile.  Email to admissions@mydreamsacademy.org  We look forward to welcoming you to the My Dreams Academy School community.

(Fields marked * are required.)

Student Name:

First name*

Middle name:

Last name*

Home Address:

Street*

City*

State*

Zip*

Country*

Phone Number*

Email Address*

Emergency Contact:

First name*

Last name*

Relationship*

Street*

City*

State*

Zip*

Phone Number*

Email Address*

Student Gender and Ethnicity:

Gender*

Student Academics:

Last Grade Completed*

Date of Birth [MM-DD-YYY]*

Desired Start Date [MM-DD-YYY]*

Current School:

Name*

City*

State*

Expected Graduation Date*

By typing my name below, I certify that the information I have provided on this application is accurate, true and complete. I agree to abide by the policies, rules and regulations of My Dreams Academy. I authorize my current high school to furnish all academic and personal information requested by the Office of Admissions at My Dreams Academy. I authorize My Dreams Academy to report my academic progress to the local school district. I understand that my enrollment will be limited to courses approved by My Dreams Academy academic advisors. I understand that the one-time enrollment fee is non-refundable once it is paid. I understand that I may arrange for a payment plan for tuition fees. I understand that if a payment plan is cancelled, I am still responsible for all tuition fees due to the date of withdrawal. I agree that a tuition fee is charged for each month of attendance. I understand that my student has 365 days to complete a school year. At the end of 365 days I may request an extension that will allow an additional 60 days access for an extension fee.

Signature*