HOPE Academy FAMILY ENROLLMENT APPLICATION. A. FAMILY INFORMATION Please complete the following to help us learn more about your family:

Transcription

1 HOPE Academy FAMILY ENROLLMENT APPLICATION A. FAMILY INFORMATION Please complete the following to help us learn more about your family: of Application Father s Name: Employer: Business Phone : Cell Phone: Mother s Name: Employer: Business Phone : Cell Phone: Child #1 Name: Age: Enrolling? Yes / No Child #2 Name: Age: Enrolling? Yes / No Child #3 Name: Age: Enrolling? Yes / No Child #4 Name: Age: Enrolling? Yes / No Child #5 Name: Age: Enrolling? Yes / No Who do the children reside with? Both Parents / Mother / Father / Other Home Address: City: State: County: Zip Code: Home Phone: ( ) Enter Primary

2 B. STUDENT INFORMATION Fill out a separate student information form for each child enrolling: Full Name: D.O.B: / / Age (as of Sept.1st): Preferred Name: Gender: Grade applying for: Student Enrolled: Academic Days Student Support Days 1. Has your child ever attended public school? Private School? Name of school(s): s attended 2. Has your child ever been home schooled? If yes, what grade(s)? 3. Has your child ever skipped a grade(s)? If yes, which grade(s)? 4. Has your child ever repeated a grade(s)? If yes, which grade(s)? 5. Has your child ever been suspended from a school setting? If yes, please explain below 6. Please describe your child s academic strength s and/or weakness s: 7. Does your child have any learning, social, physical, or emotional difficulties that may affect learning or school activities? 8. Do you have behavioral concerns for this child? 9. Please try to describe your child s level of spiritual maturity: 10. Please describe your child s favorite activities, school subjects, and hobbies:

3 C. EMERGENCY CONTACT INFORMATION Please list individuals who are authorized to pick up your child if you are unavailable to pick up or in case of an emergency: Name: Relation: Phone: ( ) Name: Relation: Phone: ( ) Name Relation: Phone: ( ) Medical Information: Hope Academy has permission to administer the following medication to my child(ren) Tylenol Ibuprofen Advil Benadryl Does your child use any medication on a regular basis? Allergies/Medical Conditions: Physician: Phone: ( ) Preferred Emergency Medical Facility: Health Insurance: Phone: ( ) In the event of an emergency, before action is taken, every effort will be made to contact you or your designated contacts, if possible. Should your child become ill or suffer an accident, the Hope Academy staff will first pray for your child, as well as administer, call for, or secure emergency care if medical attention is deemed necessary. I, hereby authorize HopeAcademy to secure the necessary medical care for my child(ren). I also understand that any medical expense incurred will be accepted by me. Parent Signature

4 D. CHRISTIAN BACKGROUND & FAMILY TESTIMONY 1. Has your child made a profession of faith in Jesus Christ? 2. Does your family attend a local church? Yes No 3. If so, which church and how long have you been involved? 4. What community or church activities do you currently serve in? FAMILY S TESTIMONY Please share your family s testimony: STATEMENT OF FAITH I have carefully read and agree with the Hope Academy Statement of Faith and understand that my child(ren) will be taught from the biblical perspective of this statement of faith. Signature of Parent Applicant

5 E. COMPLETE ENROLLMENT APPLICATION Please be sure you have completed the following before turning in the enrollment application: Fill out the application in it s entirety to the best of your knowledge Sign the medical release, photography & video consent, and statement of faith agreement Complete a student information form for each child enrolling Bring a copy of your child(ren) s birth certificate Include your registration fee Include a copy of Declaration of Intent to home school by September 1 Family Commitment Agreement We, as the parents of, agree to partner with Hope Academy for the following school year. We believe it is ultimately the parent s responsibility for their child s / children s education. We have read the statement of faith, admission, discipline and financial policies, and the classroom methods and procedures. We are in agreement to support Hope Academy by praying for our school, helping our teachers by completing home school day assignments with our child/ children, and paying our tuition payments. Although my child is enrolled at Hope Academy, we understand that Hope Academy does not keep official school records. We will complete our Declaration of intent to home school and will continue to comply with all state homeschooling regulations. To the best of our knowledge, the information we provided in this application is true and accurate. Signature of Parents Photography & Video Consent We understand that Hope Academy regularly photographs, videotapes, or records by other visual or sound recording devices during school functions. We consent to my child's photograph, likeness or image being used by Hope Academy in video presentations, publications, and promotions on the school website or in any other lawful manner. Signature of Parents