La Grange Campus
(Elementary & High School)

6425 Willow Springs Road
LaGrange, IL 60525
708.579.9040

Burr Ridge Campus
(Transition Program Ages 17-22)

6880 North Frontage Road
Suite 100
Burr Ridge, IL 60527
708.639.4222

Mon - Fri: 8:00 a.m. - 5:00 p.m.

Admission open

708.579.9040

info@acaciaacademy.com

Student Referral Form

Please complete the application below. The Acacia Academy administration team will review the current Individualized Educational Program (IEP), 504 plan, medical records and/or all relevant information to determine if Acacia Academy has a program to meet the needs of the student.

My Infomation

School District Info

Student Info

Parent/Guardian Info

Click or drag files to this area to upload. You can upload up to 3 files.
Please provide documents in PDF or Microsoft Word formats.
Click or drag files to this area to upload. You can upload up to 3 files.
Please provide documents in PDF or Microsoft Word formats.