Pinellas Gulf Coast Academy Application
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Pinellas Gulf Coast Academy Application
Welcome to our School application. Thank you for your interest in our school. Once the application is completed and submitted, a faculty member will contact you. (Please Note) If your student is coming from out of the state, out of county, or Private School, transcripts from the previous school will need to be provided. If you have any questions please call our school at 727-474-8836
1.
Student Name
*
2.
Date of Birth
*
MM/DD/YYYY
3.
Program you'd like your student considered for
ex. Online or In Person Learning. If online selected, please provide your reasoning as to why you would like to be considered for our online learning program.
--None--
Online Learning
In Person
4.
Student Current Age and Grade
*
ex. 9th 10th 11th 12th
5.
Please provide your reasons for your student to be considered for the online program
If selected online learning as your answer for the previous question. Please provide full detailed reasoning for consideration
6.
School Currently Enrolled
*
Please Provide School Full Name, Address, Phone and Fax Number
7.
Where is your student coming from
*
If your student is coming from Out of State, Out of County, or Private School, the transcripts from the students previous school must be submitted before the application is reviewed. Please email transcripts to pettermona@pcsb.org or fax to 727-581-9557
--Please Select--
Pinellas County Schools
Out of State or County
Private School
8.
Student Address
*
Address
City
State
Zip Code
Address City State Zip Code
9.
Student Phone Number
10.
Student Email Address
*
11.
Parent/Guardian Name
*
Full First and Last Name
12.
Parent/Guardian Contact Number(s)
*
Cell
Work
Alt/Home
Parent/Guardian Contact Number(s)
13.
Parent/Guardian Email Address
*
14.
Add'l Caregiver
15.
Relationship to Student