Harpswell Coastal Academy – Declaration of Intent to Enroll form

We would love to hear from you! Please fill out this form and we will get in touch with you shortly.

I wish to enroll in Harpswell Coastal Academy for the 2013-2014 academic year. *
- Sixth Grade
- Ninth Grade
Student Personal Information:
First Name*
Last Name*
Date of Birth*
Street Address*
City*
State*
Zip Code*
Email Address*
Phone number*
School and Education Information:
I am Currently: *
- Home schooled
- Enrolled in public school
- Enrolled in private school
Enter your current school name
Parent/Guardian Information:
Mother:
First Name*
Last Name*
Street*
City*
State*
Zip Code*
Phone Number*
Email Address*
Father:
First Name*
Last Name*
Street*
City*
State*
Zip Code*
Phone Number*
Email Address*
How did you learn about HCA?*
*Submission of this form is not a guarantee of enrollment as we have a limited number of slots available. If there are more students seeking admission than available slots, a lottery drawing for 30 6th graders and 30 9th graders will be conducted at 3:00 p.m. on FRIDAY, MARCH 29, 2013.
Address
Street AddressAddress Line 2CityState / Province / RegionZip / Postal Code

Country

A Public Charter School Serving Grades 6–12