Somerset Academy - Fostering achievement and developing minds. Call 305.740.0509

Waiting List

How many children are you submitting an application for?

Student 1
Last Name *
First name *
Middle Initial
Student’s D.O.B * / MM / DD YYYY
Gender Male Female
Name of School Currently attending *
Incoming Grade level for 2012 /2013 School Year
Name of parent or guardian
First Name *
Last Name *
Relationship with student *
Number & Street *
Apt#
City *
Zip Code *
State *
Email *
Phone - (###) - ### ####
Name of parent or guardian
First Name *
Last Name *
Relationship with student *
Number & Street *
Apt#
City *
Zip Code *
State *
Email *
Phone - (###) - ### ####
Your privacy is important to us. Somerset Academy will not share, sell or disclose your personal information to third parties. It will only be used to transmit information pertaining to our organization.
If the school offers a bilingual program, which language would you choose?
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This form may be accepted as a formal application pending final approval process.