Public School Academy Student Inquiry Form

Student Information

First Name*

Middle Name

Last Name*

Email Address*

Birthdate*

Mailing Address*

Country

Street

City

Region

Postal Code

Cell Phone

I would like to receive text messages from SVSU

Home Phone

Preferred Language

Public School Academy Information

High School Graduation Year

School Attended:

Which grades did you attend this school? Check the box next to each grade that you attended at the school listed above.

6th Grade

7th Grade

8th Grade

What is the Name of the High School you plan to attend?

Parent Information

Parent or Guardian First Name*

Parent or Guardian Last Name*

Parent or Guardian Email*

Parent or Guardian Phone*