Tidewater Adventist Academy Intent to Enroll 2023

Intent to Enroll

2023-2024
To whom it may concern, I am committed to enrolling my child(ren) in Tidewater Adventist Academy for the 2023-2024 academic school year. To demonstrate my commitment, I am including a $100 deposit (per student) with this form. I understand that this deposit will be applied toward Registration & Enrollment Fees which will be charged in July 2023 and is non-refundable. This form and accompanying deposit must be received prior to April 30 in order to receive an additional $100/student discount to be applied to registration/enrollment fees billed in July.
Please confirm enrollment type below*

Traditional enrollment (everything above applies)Home School Connection (deposit will be applied, but no additional discounts)Other
Parent/Guardian Signature*

Clear
Student 1: *

First NameLast Name
Student Birthday*

MonthDayYear
Date
If not attending TAA, what school is your student currently attending? What is their current grade?*
Student 2:

First NameLast Name
Student Birthday

MonthDayYear
Date
If not attending TAA, what school is your student currently attending? What is their current grade?
Student 3:

First NameLast Name
Student Birthday

MonthDayYear
Date
If not attending TAA, what School is your student currently attending? What is their current grade?
Student 4:

First NameLast Name
Student Birthday

MonthDayYear
Date
If not attending TAA, what School is your student currently attending? What is their current grade?
Name of Mother/Guardian*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Name of Father/Guardian*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Are you interested in taking on a leadership role within our Parent/Teacher partnership groups?

YesNo
Do you have skills/experience that you would be willing to share that might benefit our school?

YesNo
If you answered YES, please describe.
Payment to reserve your student's space can be paid via this form. If you choose not to pay via Jotform, you'll be invoiced from Quickbooks. The invoice must be paid prior to April 30 in order to qualify for the additional discount of $100 which will be applied to your registration/enrollment fees.
prevnext( X )
Student Deposit for RegistrationI understand that a deposit of $100.00 will be applied toward Registration & Enrollment Fees for the 2021-2022 school year. A convenience fee of $3.00 has been added to this total.
$103.00 Quantity

Total

$0.00

Payment Methods

Debit or Credit Card

First Name

Last Name

Credit Card Number

Security Code

Card Expiration

Please click one of the PayPal options to complete payment and submit the form.

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