Student Enrollment - Gulfstream Goodwill

Application

Please submit the following information to inquire about eligibility and enrollment into the Career Academy’s program. For all questions, please contact Lisa Richards @ info@careeracademypb.org

Student First Name

Student Last Name

Student Date of Birth

Student Address

Guardian First Name

Guardian Last Name

Guardian Address

Guardian Cell

Home Phone

Has the student earned and deferred their diploma?

Yes No Not Sure

Is the student currently enrolled in another program in Palm Beach County?

Has the student been suspended from school within the last 12 months?