Thank you for your interest in EdOptions Academy. Please fill out the application below with your information.

Once you click on "Submit", your account will be created and you will also receive an email with your account information and additional instructions.

If you have any questions, you can contact us at 866-890-8153 or via email at

Basic Information
First Name: Last Name:
Preferred Name: Middle Name:
Gender: Date of Birth:

Street: City:
State: Country:
Postal Code: Student Phone 1:
Student Email: Student Phone 2:

Grade Level: Course Type:
Interested In: Currently Enrolled In:
Current School:
What courses are you interested in?

Legal Guardian 1 Legal Guardian 2
Relationship: Relationship:
Last Name: Last Name:
First Name: First Name:
Email: Email:
Phone 1: Phone 1:
Phone 2: Phone 2:

Additional Information
How Did you Find Us?
Section 504:
NCAA Eligible: