La Academia Lottery Form

Para ver la inscripción en español HAGA CLIC AQUI

For more information about our Lottery Enrollment Process Click Here (PDF)

Date: May 18, 2025
Student's Name: Last: First: Middle Initial:
Home Address: Street City, State Zip
Incoming Grade:
Mother/Guardian: Name: Cell Phone: Email:
Father/Guardian: Name: Cell Phone: Email:
Siblings Attending La Academia Dolores Huerta?        Name of Sibling(s):