Skip Navigation

Request Information

Thank you for your interest in our school!

Please fill out the form below and our Admissions Office will contact you and provide the information you desire.  If you'd like to contact our office directly please call 352-735-0355 or email admissions@mdcacademy.org.

* Indicates a required field.

Parent / Guardian Information
  • First Parent / Guardian
  • Last Name *
  • First Name *
  • Salutation
  • Email Address *
  • Gender
  • Cell Phone
    (Ex: 999-999-9999)
  • Home Phone
    (Ex: 999-999-9999)
  • How Did You Hear About Us? *
    Details:
  •  
  • Student 1
  • First Name *
    Last Name *
  • Birthdate
    (mm/dd/yyyy)
    Gender
  • Grade Level of Interest *
    School Year *
  • Student Interests
    Athletics
    Fine Arts
    Other
  • Current School
  • Other interests:

  •  
  • Is There Another Student?
    Yes No
  •  
  • Parent / Guardian Notes
  •