Oak Forest Academy Operated by Amite Independent School 600 Walnut St. Amite, Louisiana 70422 TELEPHONES: (985) 748-4321 FAX: (985) 748-4320 Jason H. Brabham Administrator-Principal Kay Christmas Elementary Principal Loren Lee Guidance Counselor APPLICATION FOR ADMISSION PROSPECTIVE STUDENTS 2019-2020 Please complete the student information for EACH student who will be attending Oak Forest Academy during the 2019-2020 school year. All forms must be completed for each student and the following documents are required at the time of registration. No Application for Admission will be considered without all required information and fees. Application for Admission Educational Contract Membership Fee (one time family fee) Registration Fees Bank Draft Form (10 month, 12 month and aftercare) Report Card, most recent (Grades 1-12) Birth Certificate Social Security Card Immunization Record If you should have any questions, please contact Denise Hanson, Administrative Assistant, 985-748-4321.
Oak Forest Academy Tuition & Fees for 2019-2020 New Students # of Children Registration Fees (per Family) Due at the time of Registration Capital Improvement & Maintenance Registration Fees (per # Students) Due at the time of Registration Technology & Re-Enrollment Due 6/18/19 Annual Tuition Drafted on 5 th or 17 th of each month 12 Month Bank Draft Drafted on 5 th or 17 th of each month 10 Month Bank Draft 1 $500 $200 $4977 $420 $499 2 $500 $400 $8461 $710 $848 3 $500 $600 $11,198 $940 $1120 4 $500 $800 $12,940 $1085 $1295 5+ $500 $1000 $16,175 $1350 $1618 Returning Student Registration will begin Tuesday, February 12, 2019 and will end Wednesday, February 20, 2019 All tuition must be current, remain current and all registration fees must be paid in full in order for registration to be complete Sibling Registration is February 25-26, 2019 Alumni Registration is February 27-28, 2019 New Student Registration is March 12-15, 2019 3% processing fee will be charged to accounts on credit card payments & online transactions.
Application for Admission Oak Forest Academy 2019-2020 ALL information is required, please print New Student 1: Full Name: Application For Grade: LAST FIRST MIDDLE Preferred Name Date of Birth Social Security # Race American Indian Asian Gender Black Hispanic Native Hawaiian Two or more races Student Email White Student s Address MAILING ADDRESS CITY STATE ZIP Home Phone # (NOT CELL) _ Student Cell # (NOT PARENT) Name of present school: MAILING ADDRESS CITY STATE ZIP Has the applicant ever been expelled, denied re-enrollment at a school, or counseled not to return to a school: Yes No If yes, please explain: Has the applicant ever been the subject of any major school disciplinary action? Yes No If yes, please explain: Has the applicant ever been the subject of any law enforcement action? Yes No If yes, please explain: Is applicant currently taking prescribed medication? Yes No If yes, please provide the name(s) of the medication(s): Please explain any medical concerns: _ Physician: Phone: Psychologist: Phone: Has this student been diagnosed with any educational or behavioral needs; developmental delays; particular physical, mental or emotional needs. If yes to any, please explain: Attach a copy of any educational plans
Application for Admission Oak Forest Academy 2019-2020 ALL information is required, please print New Student 2: Full Name: Application For Grade: LAST FIRST MIDDLE Preferred Name Date of Birth Social Security # Race American Indian Asian Gender Black Hispanic Native Hawaiian Two or more races Student Email White Student s Address MAILING ADDRESS CITY STATE ZIP Home Phone # (NOT CELL) _ Student Cell # (NOT PARENT) Name of present school: MAILING ADDRESS CITY STATE ZIP Has the applicant ever been expelled, denied re-enrollment at a school, or counseled not to return to a school: Yes No If yes, please explain: Has the applicant ever been the subject of any major school disciplinary action? Yes No If yes, please explain: Has the applicant ever been the subject of any law enforcement action? Yes No If yes, please explain: Is applicant currently taking prescribed medication? Yes No If yes, please provide the name(s) of the medication(s): Please explain any medical concerns: _ Physician: Phone: Psychologist: Phone: Has this student been diagnosed with any educational or behavioral needs; developmental delays; particular physical, mental or emotional needs. If yes to any, please explain: Attach a copy of any educational plans
Application for Admission Oak Forest Academy 2019-2020 ALL information is required, please print New Student 3: Full Name: Application For Grade: LAST FIRST MIDDLE Preferred Name Date of Birth Social Security # Race American Indian Asian Gender Black Hispanic Native Hawaiian Two or more races Student Email White Student s Address MAILING ADDRESS CITY STATE ZIP Home Phone # (NOT CELL) _ Student Cell # (NOT PARENT) Name of present school: MAILING ADDRESS CITY STATE ZIP Has the applicant ever been expelled, denied re-enrollment at a school, or counseled not to return to a school: Yes No If yes, please explain: Has the applicant ever been the subject of any major school disciplinary action? Yes No If yes, please explain: Has the applicant ever been the subject of any law enforcement action? Yes No If yes, please explain: Is applicant currently taking prescribed medication? Yes No If yes, please provide the name(s) of the medication(s): Please explain any medical concerns: _ Physician: Phone: Psychologist: Phone: Has this student been diagnosed with any educational or behavioral needs; developmental delays; particular physical, mental or emotional needs. If yes to any, please explain: Attach a copy of any educational plans
Application for Admission Oak Forest Academy 2019-2020 ALL information is required, please print New Student 4: Full Name: Application For Grade: LAST FIRST MIDDLE Preferred Name Date of Birth Social Security # Race American Indian Asian Gender Black Hispanic Native Hawaiian Two or more races Student Email White Student s Address MAILING ADDRESS CITY STATE ZIP Home Phone # (NOT CELL) _ Student Cell # (NOT PARENT) Name of present school: MAILING ADDRESS CITY STATE ZIP Has the applicant ever been expelled, denied re-enrollment at a school, or counseled not to return to a school: Yes No If yes, please explain: Has the applicant ever been the subject of any major school disciplinary action? Yes No If yes, please explain: Has the applicant ever been the subject of any law enforcement action? Yes No If yes, please explain: Is applicant currently taking prescribed medication? Yes No If yes, please provide the name(s) of the medication(s): Please explain any medical concerns: _ Physician: Phone: Psychologist: Phone: Has this student been diagnosed with any educational or behavioral needs; developmental delays; particular physical, mental or emotional needs. If yes to any, please explain: Attach a copy of any educational plans
Application for Admission Oak Forest Academy 2019-2020 Parent s Names and information are required. Please print. Father s Full Name Legal Guardian (Male) Mother s Full Name Legal Guardian(Female) Preferred Name Preferred Name Home Address Home Address Home Phone # Home Phone # Cell Phone # Cell Phone # _ E-mail E-mail _ Employer Employer _ Business # Business # _ OFA Alumnus? Yes No Graduation Year OFA Alumnus? Yes No Graduation Year Maiden Name _ Check all that apply: Parents Married Parents Separated Single Parent Divorced Mother Deceased Father Deceased Student lives with (Check all that apply): Mother & Father Mother Father Guardian(s) Stepmother Stepfather If parents are divorced or separated, to whom should correspondence be sent? Both Parents Mother Father If parents are divorced, who has legal custody? Joint Custody Mother Father PLEASE ATTACH ANY LEGAL DOCUMENTS REGARDING CUSTODY AND/OR VISITATION
Application for Admission Oak Forest Academy 2019-2020 EMERGENCY CONTACT and PICK-UP INFORMATION Person to contact in an emergency (if parents cannot be reached): 1. Name: Phone Number:_ Relationship to child/children: 2. Name: Phone Number:_ Relationship to child/children: Person authorized to pick-up child/children: 1 Name: Phone Number:_ Relationship to child/children: 2. Name: Phone Number:_ Relationship to child/children: PERMISSION TO TREAT I authorize Oak Forest Academy to administer minor or incidental first aid, such as Tylenol, Advil, etc., should my child become ill or injured while under school supervision. In the event of a more serious illness or injury, I authorize OFA to: Contact a parent or legal guardian of the student and follow his/her instructions. In the event a parent or legal guardian of the student cannot be reached immediately, the School authorities are hereby authorized to use their judgment in contacting a properly licensed physician or in transporting my child to a medical facility for treatment. If, in the opinion of the physician, my child needs medical services which require my consent and I cannot be reached, I authorize, appoint and empower the Principal or school representative to furnish on my behalf such written or oral authorization as may be so required. Furthermore, I release Oak Forest Academy and its Principal and/or representatives from any liability which might arise as a result of the medical services pursuant to such authorization. I agree to indemnity and hold harmless Oak Forest Academy, the Principal, or representative from any expenses incurred for said treatment or services. Parent/Guardian Signature:_Date or Legal Representative PHOTO RELEASE I give Oak Forest Academy permission to use photographs of my child taken on behalf of the school in newspapers, advertisements, publications, website, or other media. Parent/Guardian Signature: Date: or Legal Representative
Oak Forest Academy Operated by Amite Independent School 600 Walnut St. Amite, Louisiana 70422 TELEPHONES: (985) 748-4321 FAX: (985) 748-4320 Jason H. Brabham Administrator-Principal Kay Christmas Elementary Principal Educational Contract 2019-2020 BUILDING & MAINTENANCE FEE: A building fee (see current Tuition & Fee Schedule) of $300.00 per family is due at the time of registration (February 12 20, 2019) for all families and shall accompany the application, which application will not be considered complete until the fee is paid in full. This fee is non-refundable. CAPITAL IMPROVEMENT FEE: A capital improvement fee (see current Tuition & Fee Schedule) of $200.00 per family is due at the time of registration (February 12 20, 2019) for all families and shall accompany the application, which application will not be considered complete until the fee is paid in full. This fee is non-refundable. ADMISSION FEE: An admission fee (see current Tuition & Fee Schedule) of $150.00 per student due by May 1, 2019, which will not be considered complete until the fee is paid in full. This fee is non-refundable. TECHNOLOGY FEE: A technology fee (see current Tuition & Fee Schedule) of $50.00 per student due by May 1, 2019, which will not be considered complete until the fee is paid in full. This fee is non-refundable. TUITION: Tuition (see current Tuition & Fee Schedule) shall be paid as follows: Loren Lee Guidance Counselor Payment in full I will be making one payment for the full amount of tuition no later than June 18, 2019. If payment is made online or by credit card a 3% processing fee will be charged to accounts for this type of payments); or, 10 Month Bank Draft I have completed a bank draft authorization to pay the school in 10 equal Installments drafted on the 5 th or 17 th of each month, August May; or, 12 Month Bank Draft I have completed a bank draft authorization to pay the school in 12 equal Installments drafted on the 5 th or 17 th of each month, June May. This contract made and entered into on this the day of _, 20, by and between, hereinafter referred to as parent, guardians or legal representative, and Oak Forest Academy. WITNESSETH: For and in consideration of the sum of $ due and payable as set out in this contract, Oak Forest Academy, does hereby agree to provide education under a fully accredited curriculum in accordance with the rules and regulations as promulgated by its Board of Directors to the child or children listed below in the grade level for which said student(s) is enrolled for the 2019-2020 school year. Persons enrolling said student(s) as the parents, guardians, or legal representative hereby give their consent that the student(s) enrolled will be subject to all rules and regulations of Oak Forest Academy as promulgated by the Board of Directors. It is specifically understood by the persons enrolling the student(s) hereunder that the rules and regulations of Oak Forest Academy provide for a random drug testing/screening for all students to detect and
prevent illegal drug use. Said parents, guardians, or legal representative hereby consent and agree that said student(s) enrolled hereunder will be administrated random drug tests/screens. I have read and fully understand the drug testing/screening policy and do hereby release Oak Forest Academy from any liability whatsoever arising as a result of the drug testing/screening program. A copy of our drug testing policy is attached. This contract is essential in order that Oak Forest Academy may secure and maintain the necessary faculty and physical facilities for the education of the student(s) which the parents, guardians, or legal representative, wish to enroll in its schools for the 2019-2020 school year. I understand that by executing this Educational Contract for the 2019-2020 academic year, I am agreeing to accept the rules and regulations of the school as stated in the Student Handbook and the rule concerning payment of fees and as referred to above. I understand that I am responsible for the full amount of this contract unless released for the remainder of the balance by the Board of Directors and that I will not be eligible for any refund unless having paid tuition in full. Furthermore, I agree to the policy of the school that no student(s) will be permitted to take exams nor will grades and transcripts be released unless the account has been paid in full. The undersigned acknowledge and agree that Oak Forest Academy retains the right at any time during the period of the contract to terminate this contract and dismiss the student(s) from Oak Forest Academy, if in the sole discretion of the Administration or the Board of Directors, such action is warranted. In the event the student(s) is dismissed from the school pursuant to an in accordance herewith, then in that event, the unearned portion of the tuition (per student) shown on the contract shall constitute full damages and liquated damages (which are not punitive) in favor of the affected student(s), the parents and/or legal guardians without further recourse. OAK FOREST ACADEMY admits students of any race, color, nationality, or ethnic origin to all the rights, privileges, program and activities generally accorded or made available to students at the school. OAK FOREST ACADEMY does not discriminate on the basis of race, color, nationality, or ethnic origin in administration of our educational policies, admission procedures, or school-administered programs. However, we do reserve the right to deny admission to or dismiss from the school any student who cannot benefit by the Oak Forest Academy experience based on the student(s) past academic achievement or whose personal lifestyle is not in harmony with the stated philosophy, objectives, or policies of Oak Forest Academy, or who does not fit into the spirit of the school, regardless if the student(s) has kept all the rules of the school. Payment in full I will be making one payment for the full amount of tuition no later than June 18, 2019. 10 Month Bank Draft I have completed a bank draft authorization to pay the school in 10 equal Installments drafted on the 5 th or 17 th of each month, August May. 12 Month Bank Draft I have completed a bank draft authorization to pay the school in 12 equal Installments drafted on the 5 th and 17 th of each month, June May. For the value received I/We, in solildo, promise to pay to the order Oak Forest Academy, $ paid in 10 or 12 (please circle one) equal consecutive installments on the same day of each month thereafter until all said equal installments are paid or in one lump sum payment. In the event of default in making payment of any installment on the date required, Oak Forest Academy may at its sole discretion accelerate the payment terms as defined herein declare immediately due and payable the entire unpaid contract balance. I/We hereby authorize Oak Forest Academy to automatically draft my account in the amount of $25.00 for every bank draft which is returned unpaid until such authorization is revoked in writing. The makers, guarantors, and endorsers of this Contract hereby waive presentment, demand protest, and notice of dishonor herby agree to remain bound for the payment of this not notwithstanding any extension or extensions of time payment of it, or any part of it, made by agreement with any one of more parties hereto, and agree to pay all expenses incurred in collecting the same, including 25% attorney s fee in the event that an attorney at law in employed to enforce any provision contained herein. Signature Next Page
Educational Contract 2019-2020 Signature of Financially Responsible Party Date Printed Name: Signature of Financially Responsible Party Printed Name: Parent Name(s) (if different) (Please Print) (Please Print) Student s Name: Grade: Grade: Grade: Grade: Grade: Date Rec d Admission Fee $ OFFICE USE ONLY Payment Option_ Payment Amount$ Tech Fee $ Total Tuition $ B&M Fee $ Capital Imp. Fee $ CASH CHECK#_ Online Pymt
Financial Agreement Bank Draft Oak Forest Academy 2019-2020 Father s Name: Mother s Name: Name on Bank Acct: Name of Bank: Last First Middle ABA Routing Number: Account Number: CHECKING SAVINGS TUITION Draft Amount: $ Date of Draft: (Please circle draft date) 5 th 17 th Number of Students included in draft: Student Name(s): Please circle 10 month or 12 month draft 10 Month Draft (August May) 12 Month Draft (June May) DAYCARE Draft Amount: $ Date of Draft: (Please circle draft date) 5 th 17 th Number of Students included in draft: Student Name(s): Daycare Draft is 10 Month only, August - May **** A VOIDED CHECK MUST ACCOMPANY THIS FORM*** Attach Check Here I hereby authorize Oak Forest Academy to draw monthly drafts against my bank account as indicated in the amount stated above. The above authorization will remain in effect for the 2019-2020 school year. SIGNED: Signature Accepted by Bank Date
Drug Testing Policy The Board of Directors and the Administration instituted random drug testing for grades 7 th -12 th, as well as for the faculty, staff and Administration. There is no reason to suspect a drug problem and steps have been taken to prevent such problems. Students, faculty, and staff are chosen on a random basis. Therefore, if a student is selected, it in no way indicates that he/she is suspected of drug use. A urine sample will be taken at school and sent to a laboratory for analysis. A numbering system known only to the Administration is used for identification purposes. If a test returns positive, a conference will be arranged with the parent/guardian. Specific Testing Procedure: 1. Each 7 th -12 th grade student and all faculty and staff members will be assigned a number by the Administrator for identification purposes. 2. As many as four times a year, at the discretion of the Administration, numbers from 15% of the enrolled students in grades 7 th -12 th and also 15% of the faculty and staff will be drawn. 3. Those that have their number drawn will be required to give urine samples. 4. Collected urine samples will be taken to a lab for analysis. 5. Positive results will be handled as follows: a) The Administrator will schedule a conference with the student s parent/guardian. b) Additional drug testing will be required through the school at the parents /guardians expense in order to continue enrollment at Oak Forest Academy. c) A professional evaluation and possible counseling may be required at the parents /guardians expense in order to continue enrollment at Oak Forest Academy. d) Dismissal will occur after receiving a second positive drug test.