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LYRICAL PRE-K APPLICATION

LYRICAL PRE-K ACADEMY APPLICATION -- NOW ACCEPTING CHILD CARE VOUCHERS

Enter Student's Full Name
First Name *
Middle
Last Name *
Gender
Country
Address Line 1 *
Address Line 2
City *
State/Province *
Postal Code *
Ethnic Identity
Racial Identity
Prefix
First Name *
Last Name *
Suffix
Country
Address Line 1 *
Address Line 2
City *
State/Province *
Postal Code *
Child Lives With Parent1/Legal Guardian?
Prefix
First Name
Last Name
Country
Address Line 1
Address Line 2
City
State/Province
Postal Code
Child Lives With Parent2/Legal Guardian
First Name
Last Name
Country
Address Line 1
City
State/Province
Postal Code
First Name
Last Name
Country
Address Line 1
City
State/Province
Postal Code
First Name
Last Name
Country
Address Line 1
City
State/Province
Postal Code
Upload Copy of Immunization Record with PDF or JPG File
No file selected
BEFORE/AFTER SCHOOL
PAYMENT METHOD
Immunization Records
Orientation Required
Image Authorization
Emergency Medical Authorization
Enter Full Name
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