Smrti Academy - Student Application Form

Abington Christian Academy - New Student Application

Thank you for starting your journey with Abington Christian Academy.
Instructions for filling in the Application Form

All fields marked with an asterisk (*) are required. If it is not applicable, please fill as "N/A"

NOTES FOR CONSIDERATION:
- Upload and attach as many relevant documents (previous report cards, physical examinations, vaccination records, etc.) as possible to expedite the enrollment process.
- Once submitted, please allow 2-3 business days for application processing.
- A parent/guardian interview is required before acceptance.
- Tours may be scheduled before or after completion of the application.

Current School Information

Complete only if applicable
Name of School
Phone Number
Current Grade
Date Attended From

MonthDayYear
Date
Date Attended To

MonthDayYear
Date
Does your child require special accommodations or help in any of the following areas?

TutoringReading SupportMath SupportCurrent IEP

Student Information (Medical History)
Food Allergies, if any *
Family Doctor's Name*
Medicinal Allergies, if any *
Family Doctor's Phone*
Please list any Food or Environmental Sensitivities
i.e. Red Dye, Gluten Intolerance, etc.
Communicable Diseases the child had in the past

Chicken PoxHepatitisMumpsWhooping CoughOther
If the child has been hospitalized, list dates with reasons
Can the student take part in physical activities, sports, etc.?*

Siblings

Acceptance of Terms & Conditions and Declaration of Parent/Guardian

I, as a primary parent/guardian of the student named above, certify that the details provided are accurate and true, and that they will be used to determine eligibility to enroll at Abington Christian Academy.
Signature

Clear
Date

MonthDayYear
Date
Should be Empty: