2024-25 Palm Lane Global Academy Lottery Form

Please complete the form below. Required fields marked with an asterisk *

Student Legal Last Name*:
Student Legal First Name*:
Student Legal Middle Name:
Gender *:
Date of birth *:
Birth City *:
Birth State *:
Birth Country *:
Grade Level *:

Parent/Guardian(s) Contact Information

Contact Information

First Name:
Last Name:

Address

Street Address:
City:
State:
Zip/Postal:
Email:
Primary Phone Number:
Secondary Phone Number:
Current Vista Family? (If student have a sibling at Vista Charter Public Schools):
Please put your first and last initials as your signature:
We will send you a confirmation email with your application number and date. Please keep that email as your receipt until the lottery day. For any questions please call the school office at (657) 213-8980.

Without a valid email address and confirmation email, your online application is incomplete.
Confirmation Email *: