Anthem Classical Student Application
2021-2022 academic year
Name
*
First Name
Middle Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Gender
*
Please Select
Male
Female
School Currently Attending
*
City
*
Entry Grade (Fall 2021)
*
Please Select
Kindergarten
First
Second
Third
Fourth
Fifth
If you are interested in enrolling a 6th-8th grader, please contact us at info@anthemclassical.org before proceeding in the application.
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Educational Information
To best partner with you in educating your child, please provide an honest description of his or her educational experience through the following questions.
To the best of your ability, please describe your student's educational history including previous schools, classes, and curriculum used.
*
Describe your student's extracurricular interests and/or achievements.
*
Rate your student's learning ability
*
Struggles
1
2
3
4
5
Excels
6
1 is Struggles, 6 is Excels
Rate your student's behavior
*
Difficult
1
2
3
4
5
Excellent
6
1 is Difficult, 6 is Excellent
Rate your student's response to correction or discipline
*
Resistant
1
2
3
4
5
Receptive
6
1 is Resistant, 6 is Receptive
Has your student ever repeated a grade?
*
No
Yes
If yes, please explain
Has your student ever had an educational change of placement?
*
No
Yes
If yes, please explain
Has your student ever missed 10 or more days of school?
*
No
Yes
If yes, please explain
Has your student ever been diagnosed with a significant illness or learning disability?
*
No
Yes
If yes, please explain
At this time, Anthem is not equipped to admit students with severe learning disabilities. Students who can function independently in a classroom with limited, general accommodations can be considered for enrollment. If you would like to discuss a specific situation please contact: info@anthemclassical.org
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Family Information
Parent / Guardian Information
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State
Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Primary Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Marital Status
*
Please Select
Married
Separated
Divorced
Widow/-er
Number of children in the Home
*
Employer
*
Parent / Guardian #2 Information
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Employer
*
Please briefly share your family testimony with us so we can learn more about your family.
*
Grandparents
We love building generational relationships with families because we believe they play an integral role in forming the lives of children. If comfortable, please provide the names and email addresses of your child’s grandparents so we can keep them informed and invite them to future events.
Grandparent 1
First Name
Last Name
Grandparent 1 - Email
example@example.com
Grandparent 2
First Name
Last Name
Grandparent 2 - Email
example@example.com
Grandparent 3
First Name
Last Name
Grandparent 3 - Email
example@example.com
Grandparent 4
First Name
Last Name
Grandparent 4 - Email
example@example.com
Emergency Contact Information
Emergency Contact 1
*
First Name
Last Name
Relationship to the student
*
Please Select
Aunt
Uncle
Grandmother
Grandfather
Family Friend
Uncle
Other
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Emergency Contact 2
First Name
Last Name
Relationship to the student
Please Select
Aunt
Uncle
Grandmother
Grandfather
Family Friend
Uncle
Other
Phone Number
Please enter a valid phone number.
Email
example@example.com
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Additional Information
What church does your family currently attend?
*
Years have you attended this church?
*
Please provide a reference from your church leadership. (Pastor, community group leader, etc.)
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
How familiar are you with classical education? Please explain below.
*
How did you first hear about Anthem Classical Academy?
*
Please Select
Web Search
Social Media
Word of mouth
Friend / Family
Radio
Print Advertising
Other
What led you to apply for Anthem?
*
Please list any Anthem families who referred you.
Separate with a comma if more than one
Is there any additional information you would like for us to know regarding your student, his or her education, or your family in general?
Family Interview Preference
Day of the week
*
Monday
Tuesday
Wednesday
Thursday
Friday
Time of day
*
Morning
Afternoon
Evening
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Commitments
We expect families to be pursuing a personal walk with Jesus and affirm our Identity Commitments and Non-Discriminatory statements.
Anthem Classical Academy Identity Commitment
Anthem Classical seeks to ensure adherence to the mission and core values established by the Board of Directors as guides to our daily practice, instruction, and culture. We ask all members of our organization, including students, families, staff, and the Board, to affirm the four core components of our school. We will collect formal signatures during enrollment. If you have any concerns about the statements in these documents, please contact us before finishing your application.
*
I Affirm
Mission
Core Values
Statement of Faith
Statement of Philosophy
Non-Discriminatory Statement
Anthem Classical Academy administers its programs to qualified individuals who are Christians of good character and does not discriminate on the basis of race, color, national or ethnic origin.
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Payment, Signature, and Submission
$100 non-refundable application fee is due in order to process your application. You can process your payment here in the application and then continue down to sign and submit it.
I certify the information provided in this application is true and authorizes prior schools to provide Anthem Classical Academy with records and opinions regarding the applicants.
Please verify your application
*
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