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Program Enrollment

Are you interested in getting started with our virtual program?

Contact our office, (620) 723-1130, or complete the form below in order to receive additional information about our program. A Pre-Enrollment Questionnaire can be downloaded from our website, or you can contact the office and have one mailed to you.  Filling out the information below, or completing a Pre-Enrollment Questionnaire, does not guarantee you a spot in the 21st Century Learning Academy.  Your Pre-Enrollment Questionnaire will be reviewed by our staff to determine if you are a good fit for the program.  If you are currently enrolled in another school or program, do NOT withdraw until you have officially been accepted in to our program.

If you are 18 years of age or under, please contact Arlen Harris at the office to inquire about enrollment prior to completing this form.

PLEASE NOTE: Before submitting a request, please review our three program options on the pages dedicated to them. The 6-12 Program is designed for students who are 17 years of age and under, while the Adult Diploma Program is designed for students over 18 years of age wishing to complete their schooling. Credit Recovery is only for students currently enrolled in another school who, with the help of their school counselor, need to retake a course while remaining in that school. We no longer offer courses below 5th grade.


Please fill the required fields:


  • Select your age*:
    17 or under     18 or older

    Program choice*:
    K-12     Adult Diploma     Credit Recovery

* Required fields

Adult High School Diploma Program
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