I am completing this form to express my interest in enrolling my child in the Northwest Georgia Charter Academy serving students in Floyd County, Polk County and the City of Rome.

1. I understand that submitting this form now, in no way, guarantees my student/students enrollment at the Northwest Georgia Charter Academy, nor does it obligate me to enroll my student.

2. I understand that if the school is overfull, a lottery will be held to determine enrollment.

3. By submitting this form, I give the Northwest Georgia Academy Charter School permission to contact me in the regarding the school and enrollment.