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To be considered for admission to Icon Preparatory School, each student must submit an enrollment form which you can complete and submit below.

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Icon Preparatory School Student Registration Form

STUDENT INFORMATION

1. Student's Full Name

Grade (2021-2022)

Date of Birth

Previous School

Medical Conditions/Medications

2. Student's Full Name

Grade (2021-2022)

Date of Birth

Previous School

Medical Condtions/Medications

3. Student's Full Name

Grade (2021-2022)

Date of Birth

Previous School

Medical Conditions/Medications

How will these students get to school?

Bus

Car Rider

Walker

PARENT/GUARDIAN INFORMATION

1. Full Name

Phone

Home Address

City

State

ZIP

2. Full Name

Phone

Home Address

City

State

ZIP

EMERGENCY CONTACTS

1. Name

Phone Number

2. Name

Phone Number

Name

Phone Number

OFFICIAL TRANSCRIPT REQUEST

This is an official request and authorization for the transcripts and student records of the students listed above. Please send:

Full Cum File
Physicals
Shot records
Birth Certificate
Last report card
IEP/504 Plans

Documents may be faxed to

813-967-8300 or mailed to:

Icon Preparatory School
1906 N Rome Ave
Tampa, Florida 33607

For more information call

813-967-8300.

Authorized Signature

Date of Application

Thanks for submitting!

TRANSPORTATION TO SCHOOL

CONTACT INFORMATION