Pre-Registration Form for ILA Boulder Creek


1)Please cut and paste the Pre-Registration Form, below, and complete all parts.

2) Please make sure you read the statement at the bottom of the form before your name. 

3) Please email the Pre-Registration Form to

or mail (or hand-deliver, we would love to meet you!) to:

13200 Central Avenue, Suite 14, Boulder Creek, CA 95006.



Pre-Registration Form for ILA Boulder Creek  

For School Year: 2018-2019 or 2019-2020 (choose one)

Student's Name:  ____________

Grade Level of Student in August 2018: ____________

Parent/Guardian name(s): ____________

Parent/Guardian best contact number(s):  ____________

Parent/Guardian best contact email or electronic address(es):____________

Home address (street address, city): ____________

By submitting this form, I signify my meaningful interest to register my child(ren) to attend ILA Boulder Creek in the school year indicated above.  I understand that this form is not binding and I will be contacted to confirm my registration when the school charter is authorized.  After the public registration window has closed, if the number of applicants exceeds seventy-four students (74) my child(ren) will be entered into a public lottery for admission into ILA Boulder Creek.

Full name of person completing this form and relation to student:  ______________________________________________