Calling all students

Potential Student Form

If you are interested in having your student attend MLMPI Preparatory Academy, then simply fill out the “Potential Student Form” below so that someone from our staff can be in touch with you to discuss potential enrollment options.

Also, once you have completed the Potential Student Form below, be sure to download our Enrollment Application for the 2019/2020 school year.

Download Enrollment Application

Student's Name (First & Last)

Email Address

Phone Number

Grade Applying For:

Student's Birthday (Month, Day, Year)

Last School Student Attended

Student's Current Grade Level

Student's Florida ID #

Student Resides with:

Parent/Legal Guardian Home Phone Number

Parent/Legal Guardian Name (First & Last)

Parent/Legal Guardian Home Address (Address, City, State & Zipcode)

Parent/Legal Guardian Employer/Occupation

Parent/Legal Guardian Work Phone Number

Parent/Legal Guardian Email Address

Case Manager Name (if applicable)

Case Manager Phone Number (if applicable)

Message