North Star Academy

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Family Last Name: *

Enter Last Name of Family [One account per Household]

First and Last Name(s) of Family Volunteer(s) [Note: Last Name ONLY if Different from Family Last Name]: *

Enter First and Last Name(s) of ALL Volunteers. Reminder: Volunteers other than Parent / Guardian must complete a Community Volunteer Application.

Phone Number:

Contact # for Primary Volunteer

Carpool #:

King Soopers Loyalty Card Number [LCN]:

Enter each LCN with a &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#039;space&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#039; before last digit [e.g. 123 4] Also, Add a comma between LCNs if more than one.

Student #1 Name: *

Student #1 Grade: *

Student #1 Teacher:

Student #2 Name:

Student #2 Grade:

Student #2 Teacher:

Student #3 Name:

Student #3 Grade:

Student #3 Teacher:

Student #4 Name:

Student #4 Grade:

Student #4 Teacher:

Student #5 Name:

Student #5 Grade:

Student #5 Teacher:

Student Grade Grouping:

MS 6/7/8

4th/5th

2nd/3rd

K/1st

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About

Mission Statement
North Star Academy provides a Core Knowledge education with an integrated Spanish language program that challenges students to meet their highest potential through differentiated academic instruction and rich social and cultural experiences within a safe, orderly and nurturing environment.

www.nstaracademy.org

16700 Keystone Boulevard, Parker, CO 80134