Dream Academy Enrollment Application

Dream Academy Enrollment Application
Date

MonthDayYear
Date
Incoming Grade Level
Name of Student*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Age*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Gender*

MaleFemale
Parent's Email*
example@example.com
Ethnicity
Is the applicant child bilingual/multi-lingual?*

YesNo
Please Specify the Languages Spoken
Primary Language Spoken at Home
Please select the kind of registration you are applying for:*

New StudentTransferreeContinuing
School Transferring From
School Phone Number
Please enter a valid phone number.
Upload a digital copy/photo of the transcript or last report card

Note: you might eventually be required to submit a physical hardcopy of this document
Cancelof
Upload a Digital Copy/photo of child's Birth Certificate

Cancelof
Upload a Digital Copy/photo of child's Immunization Records

Cancelof
Upload Digital Copy/Photo Home Study Program Declaration Of Intent

Cancelof
Georgia law requires parents or guardians who teach their children at home to submit to the Georgia Department of Education (GADOE) an annual Declaration of Intent form. A Declaration of Intent must be submitted to the Georgia Department of Education within 30 days after establishment of a home study program and by September 1 annually thereafter.
The parent or guardian shall have the authority to execute any document required by law, rule, regulation, or policy to evidence the enrollment of a child in a home study program, the student’s full-time or part-time status, the student’s grades, or any other required educational information. This shall include, but not be limited to, documents for purposes of verification of attendance by the Department of Driver Services, for the purposes set forth in subsection (a.1) of Code section 40-5-22, documents required pursuant to Chapter 2 of Title 39 relating to employment of minors, and any documents required to apply for the receipt of the state of federal public assistance.

Please click the link to complete form: Click Here

Family Information
Name of Father*

First NameLast Name
Occupation
Work Phone Number
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Name of Mother*

First NameLast Name
Occupation
Work Phone Number
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Siblings*
Student Lives With*

Both ParentsMotherFatherAppointed Legal Guardian (neither parents)
Name of Legal Guardian

First NameLast Name
Occupation
Work Phone Number
Please enter a valid phone number.
Address (if not same as above)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Medical and Health Information
Is your child taking any medications at home or at school?*

YesNo
Please provide details
Does your Child have any allergies to any of the following: Insect Bites, Food, Seasonal Allergies, Latex, Medicine, etc.*

YesNo
Please provide details

Student Name

First NameLast Name
Birthdate

MonthDayYear
Date
Grade
Most Recent School Attended
School Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
School Number
In accordance with the federal regulations regarding the privacy rights of parents and students under the Family
Educational and Privacy Act of 1974, the undersigned hereby consents release to Dream Film Academy of all
educational records (including statement of disciplinary action or disciplinary records) and other information as may be requested about the above-named individual.
Signature

Clear
Date

MonthDayYear
Date
To Principal or Guidance Counselor:
We would appreciate you promptly sending the following documents to the address below:
• Complete transcript and latest grades
• Copy of Birth Certificate
• Standardized test results
• Any special testing results or placement in special programs
• Certificate of immunization and all health records
• All disciplinary records or official statement of disciplinary action

Email:Dreamacademyatl@gmail.com

Address: 2244 Panola Rd. Lithonia Ga.

Phone: 404-566-6262
- Parent/Guardian and Student Conduct Policy.
  • Students and parents/guardians will be respectful of the teachers and administration.
  • Dream Film Academy reserves the right to expel any student whose parent/guardian fail to cooperate with
  the administration.
  • Dream Film Academy has a no tolerance policy for student misconduct and failure to meet academic
  standards.
  • Students that continue to violate the conduct policies or fail to meet academic expectations of Dream Academy may be dismissed at the discretion of the administration.
  Attendance Policy
  • Attendance to scheduled classes is mandatory
  • Parents or guardians must contact the school office if the student is going to be absent for any reason.
  • The student will be responsible for contacting all of his/her teachers in order to obtain the homework assignments for the days missed.
  • Late work during the grading period is penalized.
  Campus Arrival/Departure and Student Drivers Policy
  • Parents or guardians will pick up students on time.
  • Student drivers must adhere to the following rules:
  o 5mph speed limit on school campus
  o No loud music allowed in the parking lot or on school ground.
  o All cars must be parked in a proper parking space between the white lines.
  
  Media Release
  • Parents/guardians and students hereby grant Dream Film Academy the right to photograph, videotape, or otherwise digitally collect student’s likeness, voice, and sounds (as “Works”) during the student’s presence at Dream Academy and Dream Academy sponsored events and assign and grant all rights in
  these Works to Dream Film Academy.
  • This gives Dream Film Academy the right to use or sublicense the Works and student names, likenesses and
  biographies, in Dream Film Academy’s discretion, in all media, for the promotion of Dream Film Academy and its mission and program.
  • Dream Film cademy events are semi-public events that may be attended by members of the press, business
  corporations, and media (“commercial guests”) not under the control of Dream Academy who might photograph or videotape the event.
  • Dream Film Academy asks all commercial guests to comply with the Dream Academy policy of not printing a minor’s name with his/her picture, and Dream Academy asks them not to use images of the participants or attendees for the commercial purposes without obtaining specific written permission from the person or a minor’s parent or guardian.
  This agreement will be governed by and construed in accordance with the laws of the State of Georgia.
  I have read the Admissions Agreement and agree to abide by the above-stated terms and conditions.
  
  For Middle and High School students only:
  I understand and agree to abide by the above-stated terms and conditions, as well as all policies,
  requirements and rules set forth.
Name

First NameLast Name
Signature

Clear
Acknowledgement, Authorization, and Consent
By signing this form, I hereby authorize the school to use the information herein provided for the processing of my child's application. I understand that the information shared herein shall be for the purpose of the admission of my child. I authorize and provide consent to the school in releasing my child's medical and health information with the school's health services. In the event that my child becomes ill, sustains an injury, or in any case, needs immediate medical care during under the care and supervision of the school, I hereby authorize the school to administer first aid for my child's relief. In the event that my child needs immediate attention and it is not practical to wait for receiving instructions from the parents or appointed legal guardian or the child, I, as a parent/legal guardian, hereby authorize the school, its staff, to act as agents in delivering my child to a hospital and performing decisions necessary as recommended by an attending physician for the care of my child such as conducting X-ray, anesthetic, and other medical treatments such as surgery. I further declare that the information I have provided in this form is true and correct to the best of my knowledge.
Signature of Parent/Guardian

Clear
Name

First NameLast Name
Date

MonthDayYear
Date
Should be Empty:

Dream Academy Enrollment Application

Family Information

Medical and Health Information

Acknowledgement, Authorization, and Consent