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Umbrella Program Enrollment Application
This application must be filled out for
each
student seeking enrollment into The Academy's Umbrella Program for the 2022-2023 school year. Tuition will be invoiced upon acceptance.
All admissions decisions are made after carefully examining the applicant’s previous academic records and considering the well-being of both the student and The Academy for G.O.D. Umbrella Program as a whole.
By completing this form you are certifying that all information provided is true and correct according to the best of your knowledge, and that you understand the scope of the Academy for G.O.D. Umbrella program.
The Academy for G.O.D. is an ACSI member school and is in compliance with their expectations for members, abiding by all criteria listed on their website. For more information, please visit
www.acsi.org
.
Email
Student First Name
Student Last Name
Please upload a photo of your student.
Upload File
Upload supported file (Max 15MB)
Applicant's Gender
*
Male
Female
Applicant's Date of Birth (mm/dd/yy)
Grade Level Completed (Please list the grade level the applicant completed in the previous semester)
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
PreK/None
Other
Applicant's Home Address
Home Address Line 2
City
Region/State/Province
Postal / Zip code
Country
Country
Primary Teacher Relation (The Primary Teacher and student must reside in the same house. Legal documents are required for guardians or other agents.)
*
Mother
Father
Legal Guardian
Other
Primary Teacher's Education Level (Indicate the level of education completed by the Primary Teacher.)
GED
High School Diploma
College Degree
Other
Mother's First Name
Mother's Last Name
Mother's Phone Number
Mother's Email Address
Father's First Name
Father's Last Name
Father's Phone Number
Father's Email Address
What is the marital status of the applicant's parents?
Married
Divorced
Seperated
Other
Was your student being taught at home prior to this enrollment?
*
Yes
No
If you answered "yes" to the above, how many years has the student been homeschooled?
If you answered "no" to the above, is student transferring from a private or public school?
Private School
Public School
Other
Name of Previous School (if applicable)
Address of Previous School (if applicable)
Number of Years at Previous School (if applicable)
Does student have any IEP's or Special Education Reports? (If "yes", please upload these documents in the question below.)
*
Yes
No
Other
IEP/Special Education Documents (upload here)
Upload File
Upload supported file (Max 15MB)
Disciplinary Action: Has the student ever been suspended from school? If "yes," please give the date and explain in detail why.
Legal Action: Has the student ever been arrested? If "yes," please give the date and explain in detail why.
Birth Certificate: Please attach your child's Birth Certificate
Upload File
Upload supported file (Max 15MB)
Immunization Record: Please attach an up-to-date immunization certificate or an exemption notice for your child.
Upload File
Upload supported file (Max 15MB)
How did you hear about our school?
I would like to use The Academy curriculum at home, through their online LMS (Learning Management System).
*
Yes, I am interested in using Academy curriculum online.
No, I will be using an alternative curriculum or combination of curriculums for my student.
Other
Additional Information: Use the space provided to inform school administration of any other information you feel is pertinent to your child's application process.
I am aware of the Umbrella Program prices and policies.
*
Yes
No
Submit Application
Thank you for your application!
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