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Child's Full Legal Name:

First: *

Middle:

Last: *

Child's Current Grade: *

Child's 2023-2024 Grade: *

Your child will be registered for the Lottery Drawing for the grade you select here. Please be sure it is accurate.

By checking below, you agree that the 2023-2024 grade entered above is the correct grade for the 2023-2024 Lottery drawing. If the wrong grade is submitted, it could affect placement of your child in the correct grade. *

I agree that the correct 2023-2024 grade was entered.

Name of last school child attended: *

Child is: *

Mailing Address

Street: *

Please use proper capitalization when filling out the name fields. (ex: "John Doe" not "john doe")

City: *

Please verify spelling, capitalization, and full name of city. (ex: "New Port Richey" not "npr" or "NPR")

Zip: *

Primary Home Phone Number: *

The phone number must be entered in the following format: XXX-XXX-XXXX.

Child's Date of Birth: * Please use MM/DD/YYYY format.

Please note: An email address is required to submit a Lottery Registration form. You are able to set up a free email account through services such as Yahoo or Google. If this is still not an option, please contact our Student Services Department at 727-857-6922.

Email Address: *

Confrim Email Address: * Email addresses do not match.

Child resides with: *

Parent/Guardian #1 First Name: *

Parent/Guardian #1 Last Name: *

Parent/Guardian #1 Cell Phone Number: *

The phone number must be entered in the following format: XXX-XXX-XXXX.

Parent/Guardian #1 Work Phone Number:

The phone number must be entered in the following format: XXX-XXX-XXXX.

Parent/Guardian #2 First Name:

Parent/Guardian #2 Last Name:

Parent/Guardian #1 Cell Phone Number:

The phone number must be entered in the following format: XXX-XXX-XXXX.

Parent/Guardian #1 Work Phone Number:

The phone number must be entered in the following format: XXX-XXX-XXXX.

Are either parent/guardian an employee or Board Member of Collaboratory Prep? * YesNo

Please note only full or part time employees are eligible for employee status when submitting a Lottery application. Substitutes do not meet this criteria and therefore do not qualify for employee status when submitting a Lottery application.

If 'Yes', what position?

Does this applicant have any school age siblings (grades Kindergarten - 11th) who are CURRENTLY enrolled at Collaboratory Prep? If 'Yes', please complete name(s)/grade(s) below.* YesNo

To answer 'Yes' the students MUST have the same parent(s) OR have legal documentation of guardianship to the same person/parent.

First Name:

Last Name:

Teacher:

Current Grade:

First Name:

Last Name:

Teacher:

Current Grade:

First Name:

Last Name:

Teacher:

Current Grade:

Do you currently have any other school age siblings residing in the house who are NOT currently enrolled at Collaboratory Prep that you would like to enroll for the 2023-2024 school year?* YesNo

If you answered Yes above, please enter each sibling below. Please be advised that in addition to listing siblings below, you MUST complete a Lottery Registration form for EACH sibling you would like to register for the Lottery Drawing.

First Name:

Last Name:

2023-2024 Grade: *

First Name:

Last Name:

2023-2024 Grade: *

First Name:

Last Name:

2023-2024 Grade: *

How did you hear about us?:

If other, please specify:

By checking below, you understand that other siblings who you would like to enter into the Lottery Drawing must have a separate application completed for EACH sibling to be entered into the Lottery Drawing for the 2023-2024 school year. * I understand that each sibling must have a separate Lottery Registration form completed.
This student does not have any other siblings to be entered into the Lottery Drawing.

Please read and agree to the Terms of Registration below: * Priority enrollment at Collaboratory Prep is given to the children of Collaboratory Prep employees and to siblings of enrolled students. In order to verify sibling status, proof of a shared parent via Birth Certificate, legal documentation of marriage, or custodial papers must be available upon request.
Parents/Guardians will be notified via email on or before regarding the enrollment status of their student. Parents/Guardians must accept or decline the enrollment opportunity within 3 business days of being notified their student has been accepted into Collaboratory Prep. If acceptance notification is not received by Collaboratory Prep within 3 business days, the opening will be offered to the next student on the waiting list.
Students who are not accepted through the lottery process will be placed on the 2023-2024 waiting list in order of their lottery number.
Students submitting online Lottery Registration forms after Open, will be placed at the end of the 2023-2024 waiting list in the order in which they are received, and will not be included in the Lottery draw.
The waiting list does not roll over to the following school year; therefore, if your student does not enroll in Collaboratory Prep during the 2023-2024 school year, you will need to reapply in March 2024 for the 2024-2025 school year.
By agreeing and submitting this form you are acknowledging that you are the legal parent/guardian of the child listed on this form, that the information you have provided on this form is accurate, and that you have read and understand the Lottery guidelines as listed above. You also confirm that the contact information listed on this form is accurate.

I have read and agree to the terms and conditions.

Please be sure to scroll through and read the entire Terms of Registration section.

Please type your full name as confirmation that all information is correct, and that you have read the Terms of Registration. *

By entry above, you are agreeing that all information entered on this form is true and correct, that you agree to the above information, and this entry will be considered your electronic signature.

APPLICATION

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Waiting List

Siblings

Child's Full Legal Name: