Enrollment

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Academy Location Applying For: *

Student Name *

First

Last

Gender *

Date of Birth *

Current Grade

Ethnicity *

Former/Current School Information *

Former/Current School Name *

Address of Former/Current School

Address Line 1

Address Line 2

City

State

Zip Code

Enrollment Type *

Medical Information

Was your child receiving special education based on an IEP?

if yes, what type of disability has your child been diagnosed?

Diagnostic File Upload

Drag & Drop Files, Choose Files to Upload, or Capture With Your Camera You can upload up to 10 files.

Camera Preview

Primary Doctor Physician's Name

Phone of Primary Physician

Address of Primary Physician

Address Line 1

Address Line 2

City

State

Zip Code

Is student's immunization record up to date?

Physical Exam Upload

Drag & Drop Files, Choose Files to Upload, or Capture With Your Camera You can upload up to 10 files.

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Immunization Record Upload

Drag & Drop Files, Choose Files to Upload, or Capture With Your Camera You can upload up to 10 files.

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Parent Information

Parent/ Legal Guardian Full Name *

Phone *

Email *

Higher Education Completed

Parent/ Legal Guardian Full Name

Phone

Higher Education Completed

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Is the family a member of a local church?

*If you have answered "YES" in the above question, please indicate here what church do you regularly attend.

Employment Information of the Parent/Legal Guardian #1

Parent/Legal Guardian Name

Last Name

Name of Company or Organization

Phone Number of Company or Organization

your if Medical

Address of Company or Organization

Address Line 1

Address Line 2

City

State

Zip Code

Employment Information of the Parent/Legal Guardian #2

Parent/Legal Guardian Name

Last Name

Name of Company or Organization

Phone Number of Company or Organization

Address of Company or Organization

Address Line 1

Address Line 2

City

State

Zip Code

Photo & Video Authorization

Student Profile Photo Upload

Drag & Drop Files, Choose Files to Upload, or Capture With Your Camera You can upload up to 5 files.

Camera Preview

For student record purposes, we kindly request that you provide a recent photo of your child. This photo will be used strictly for internal documentation and will not be used for promotional or any other purposes.

I hereby grant permission for my child to be photographed and/or recorded during school activities. These materials may be used for educational, informational, and promotional purposes by the school. *

Parent/Guardian Name *

First

Last

Signature *

Clear Signature

Date *

School of ACTS

Medical Information

Parent Information

Employment Information of the Parent/Legal Guardian #1

Employment Information of the Parent/Legal Guardian #2

Photo & Video Authorization

Quick Links

Useful Links

School Info