Enroll – Matrix Entrepreneur Academy

Student Name*

Student Birthdate*

MM

DD

YYYY

Address*

Additional Address

Additional Address

Address

ADMISSIONS PREFERENCES Applications will be accepted in order of receipt of Intent to Enroll Form.

Does your student qualify for any of the preferences for admission?

PLEASE CHECK YES OR NO FOR EACH CATEGORY:

Siblings of existing students*

Yes
No

Children of employees of Matrix Entrepreneur Academy*

Yes
No

Students residing in Kern County*

Yes
No

How did you hear about Matrix Entrepreneur Academy? (For informational purposes only)*

Another Parent
Friend of my Child
School
Facebook
Instagram
Google
Email
Church
Other

Other

With the Registration Packet due on Friday, May 15, 2020, Matrix Entrepreneur Academy students and parents will be required to sign that they have read and understood the Student/Parent Handbook. A copy of the handbook is on the website.

Consent1

I agree to read and understand the Student/Parent Handbook.

Enrollment packets MUST be completed and returned along with a nonrefundable deposit of $500 with all required documentation no later than Friday, May 15, 2020. Admission may be forfeited if the completed packet is not received by this deadline or a $100 late fee may apply.

Consent2

I have read, understand and agree with the Enrollment Packet expectations.

Consent3

My student is interested in Partial Scholarship Information.

By signing below, I agree that all of the information provided is accurate and truthful to the best of my knowledge and belief.

Signed under penalty of perjury under the laws of the State of California. By signing, I understand that if any of the information contained herein is determined to be false, this form will be considered void.

Typing is the same as signing the document.

Parent 1 / Guardian Name*

Email 1*

Work Phone 1

Cell Phone 1*

Parent 2 / Guardian Name

Email 2

Work Phone 1

Cell Phone 1*

Student Name*

Student Email

Student Cell Phone

Student Other Phone

Current School*

Current Grade*

School in 2020-2021*

Grade in 2020-2021*

Please tell us your availability by choosing Available, Unavailable, or Maybe

Times may be adjusted based on student availability. Options are available for students in afterschool programs or schools ending 3:00 pm or later.

9:00-11:30 AM Suggested for Students who work independently.

12:15-2:45 PM Suggested for Athletes, Band, and other in afterschool programs. High School students would take 1 or 2 classes through Kern Learn.

3:00-5:30 PM (Suggested for Students in Regular School without afterschool programs. Adjustments may be made for students whose school ends after 3:00 pm)

School will be held Two Days per Week:>br/>Please tell us your availability by choosing Available, Unavailable, or Maybe:

Mon.

Tues.

Wed.

Thurs.

Fri.

Each student will participate in a nonprofit and personal business.

Business Interests: (Rank your level of interest - 0 is no interest & 5 is high interest)

Event Planning

Uniform Sales

Children's Classes

Technology

Sports Camps

Product Sales

Services To Children or Adults

Graphic Arts

Other

Visual Arts (Painting, Drawing, Crafts, Jewelry) Sales Online & Local Shows

Performing Arts (Perform at Conventions, Company Events, Backyard Parties, etc.)

If the Production Team is your interest, please check your preferences:

Production Team or Instrument Ensemble

Singing
Dancing
Acting
Playing an Instrument
Emcee/Disc Jockey
Tech/Stage Crew

List Friends/Family who are Entrepreneurs, Business Owners, Business Leaders:

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Matrix Entrepreneur AcademyIntent to Enroll 2020-2021

PLEASE CHECK YES OR NO FOR EACH CATEGORY:

Matrix Entrepreneur Academy
Intent to Enroll 2020-2021