My TEK Lab
Minneola Elementary Charter School Enrollment Form
Parent Information
First Name
Last Name
Address 1
Address 2
City
State
Zip
Email
Phone
Student Information
Student First Name
Student Last Name
Is the student enrolled in the afterschool program?   Yes    No
Student School Grade
Payment Schedule
Choose a Session Group   Group A 3:20pm - 4:20pm   

Emergency Contact Information
Name
Phone
Relationship
Payment Information

Billing Address 1
Billing Address 2
Billing City
Billing State
Billing Zip
/   
Total Amount: $60.00
Comments
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