LIBERTY ACADEMY RE-ENROLLMENT APPLICATION FORM

Date of Re-Enrollment Application (Today's Date)

Date

Date Commenced at Liberty Academy (Month/Year)

Proposed Re-Enrollment Date (Month/Year)

Proposed Department for Re-Enrollment

KindergartenPrep School DepartmentSpecial Ed. Department (Prep)High School Department

Student's Full Name (First, Middle, Last)

Student's Gender

MaleFemale

Student's Date of Birth

Date

Student's Current Age

Student's Home Address

Student's Home Phone Number

Please enter a valid phone number.

Student's MOE E-mail Address (if already assigned one)

example@example.com

National Student Registration Systems (NSRS) Number (if already assigned one)

Mother's Name

First NameLast Name

Mother's Phone Number

Please enter a valid phone number.

Mother's Email Address

example@example.com

Mother's Occupation

Mother's Employer

Mother's Work Number

Please enter a valid phone number.

Father's Name

First NameLast Name

Father's Phone Number

Please enter a valid phone number.

Father's E-mail Address

example@example.com

Father's Occupation

Father's Employer

Father's Work Number

Please enter a valid phone number.

Guardian's Name

First NameLast Name

Guardian's Home Address:

Guardian's Phone Number

Please enter a valid phone number.

Guardian's Email Address

example@example.com

Student lives with: (Please check all boxes that apply)

Other details:

Parents separatedParents divorcedMother deceasedFather deceased

Who is financially responsible for the student:

Has the student attended another school during the period not attending Liberty Academy?

YESNOHOME SCHOOLUNKNOWN

If yes, please specify which school:

If no, please specify what type of academic support the student has been getting while not at Liberty:

Expected Grade Entry Level

Please indicate the level of your child's current academic work (Please select the option, A being the highest and E being the lowest)

Does your child have or were any learning or behavioural difficulties observed during the period the student has not been at Liberty Academy?

YESNO

If yes, please describe and be very specific

Does your child have a recent assessment (dated within the last 24 months)?

YESNO

Briefly describe your child's character, personality, tastes and interests briefly at this age:

Please state reason for re-enrollement to Liberty Academy:

SUPPORTING DOCUMENTS NEEDED

Please scan and send the following documents via e-mail to liberyatpriory@gmail.com to complete your application:

- Proof of Payment of $5000 Re-enrollment Fee

- Two Passport Sized Photographs (taken within the last 6 months)

- Copy of Last School Report (if other than Liberty Academy)

- Completed Transfer Form (if coming from another school)

- Copy of Last Assessment Report (if applicable/requested)

- Signed Parent Commitment & Statement of Faith Form

- Completed Medical Report Form (Due once accepted)

If unable to e-mail please drop off supporting documents to our main office at:

LIBERTY ACADEMY AT THE PRIORY

32 HOPE ROAD

KINGSTON 10

JAMAICA, W.I.

Tel. (876)960-5059/906-2244/ 630-0013/630-0016

N.B. The registration fee can be paid via bank transfer using the following banking information for Liberty Academy or via card/cash in the school's main office.

Account Name: Liberty Prep School
Account Type: Business Current or Checking Account No. 198013
Bank Name: The Bank of Nova Scotia (BNS)
Branch: New Kingston Branch
Branch No: 50575

Kindly send proof of payment to libertyatpriory@gmail.com if paid via bank transfer.

PLEASE NOTE THAT ALL APPLICATIONS ARE CONSIDERED INCOMPLETE AND WILL NOT BE PROCESSED UNTIL THE NECESSARY SUPPORTING DOCUMENTS ARE RECEIVED.

THANK YOU FOR CHOOSING LIBERTY ACADEMY!

LIBERTY ACADEMY AT THE PRIORY

ELIGIBILITY FOR RE-ENROLLMENT

ACADEMIC INFORMATION

PERSONAL DESCRIPTION