Intent to Enroll - Veritas Academy Chisago City MN

Students Name*

First Middle Last

Gender*

Date of Birth*

Ethnicity

Primary Contact Name*

First Last

Primary Contact Email*

Phone*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Father's Name

First Last

Is father's address same as student's?*

Mother's Name

First Last

Is mother's address same as student's?*

Desired Grade*

Is student transferring from another school?*

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Date