School Year

School*
Creative Labs Learning Center

Student's First Name

Student's Last Name*

Suffix*

Student's Address*

City*

State*

Zip Code*

Country*
AfghanistanArgentinaAustraliaBangladeshBelgiumBrazilCanadaChinaDenmarkEgyptFranceGermanyIndiaIndonesiaItalyJapanKenyaMexicoNepalNigeria

Student's Birthday*

Spouse First Name*

Spouse Last Name*

Email Address*

Spouse Last Name*

Phone Number*

First Name*

Last Name*

Student is in Pre-K, Kindergarten or First GradeStudent is in 2nd Grade or above AND has received a scholarship in the pastStudent is in 2nd Grade or above AND attended public school for six weeks in the last yearStudent is in 2nd Grade or above AND homeschooled in the last yearStudent is in 2nd Grade or above AND zoned for a low-performing school GA Low Performing School SearchStudent is in 2nd Grade or above AND has documented school-based bullying issueStudent is currently receiving or eligible for SB-10 or SB-47

$18,825.00$25,550.00$32,275.00$39,000.00$45,725.00$52,450.00$59,175.00$65,900.00$37,650.00$51,100.00$64,550.00$78,000.00$91,450.00$104,900.00$118,350.00$131,800.00$60,240.00$81,760.00$103,280.00$124,800.00$146,320.00$167,840.00$189,360.00$210,880.00

I hereby authorize Georgia SSO to release this information to your designated school.

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