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All 6th – 12th grade Students under the age of 18 will need to complete the following information in order to enroll in the 21st Century Learning Academy.  Click on the title to download a PDF version of the form.

17-18 Pre-Enrollment Questionnaire

As a first step towards potentially enrolling your child in the 21st Century Learning Academy, please take a few minutes to answer each of the following questions so that we can gain a better understanding of your child’s abilities and needs. This completed questionnaire will need to be submitted to our Office before receiving enrollment forms for your child. Completion of this form DOES NOT guarantee that your child has been enrolled in the 21st Century Learning Academy. Upon receipt of this form in our office, you will be notified within 5 business days as to whether your child has been accepted into the program.  Thank You!Please return the Pre-Enrollment Questionnaire to the following address when it is complete.


21st Century Learning Academy

730 South Main
Greensburg, KS  67054



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