Whole Kids Academy Kindergarten Admissions Application

PARENT/GUARDIAN CONTACT INFORMATION
Parent/Guardian Contact #1
Name *

Prefix First Name Last Name Suffix
Address *

Street Address

Street Address Line 2

City State

Zip Code
Primary Phone Number *

Area Code Phone Number
Alternate Phone Number *

Area Code Phone Number
E-mail *
example@example.com
Parent/Guardian Contact #2
Name

Prefix First Name Last Name Suffix
Address

Street Address

Street Address Line 2

City State

Zip Code
Primary Phone Number

Area Code Phone Number
Alternate Phone Number

Area Code Phone Number
E-mail
example@example.com
Emergency or Alternate Contact
Name *

Prefix First Name Last Name
Relation *
Primary Phone Number *

Area Code Phone Number
Alternate Phone Number *

Area Code Phone Number
Pickup Authorization

Please list the name/names of all persons authorized to pick up your child.
Name *
Phone Number *

Area Code Phone Number
Name *
Phone Number *

Area Code Phone Number
Name
Phone Number

Area Code Phone Number
Name
Phone Number

Area Code Phone Number

ACADEMIC HISTORY
Where did your child attend school last year? *
Which neighborhood school or private school do you plan to send your child upon completion of our Kindergarten program? *
Did your child attend preschool at WKA? *

Yes No
Please describe your child's experience with and ability to comprehend and speak Spanish. *
If your child did not attend WKA for preschool, please provide a letter of recommendation from a teacher or administrator from your child's school last year: *

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Does your child have any special needs? (academic, nutritional, emotional, social, etc.) *

Yes No
Please describe your child's special needs. *
Academic, nutritional, emotional, social, etc.
Does your child have an Individualized Education Program (IEP)? *

Yes No
Please share more about your child's Individualized Education Program (IEP). *
What are your primary academic goals for your child this school year? *
In what ways will your family plan to support your child's academic goals at home? *
What are your child's favorite subjects in school? *
What are your child's hobbies and interests? *
How does your child learn best? *
Has your child ever received any type of academic or school disciplinary action at their current or previous school? *

Yes No
Please explain any type of academy or school disciplinary action your child received at their current or previous school. *

COMMITMENT ACKNOWLEDGEMENT & SIGNATURE
Thank you for completing our Whole Kids Academy Kindergarten Admissions Application! A member of our administrative team will be reaching out to you in the upcoming weeks to confirm your enrollment. Once your child's spot is confirmed, you will receive an admissions packet which includes additional information and forms to be completed prior to the first day of school on August 28th. If you have any questions, you may reach out to our admissions team any time at 240.242.4957 or info@wholekidsacademy.com Thank you!
By signing and completing this admissions application, I confirm my intent for my child to attend WKA's Kindergarten program for the duration of the academic school year, beginning on August 28, 2023 and ending on June 12, 2024. Upon acceptance to the program I understand I will have one week to confirm my child's spot and make payment arrangements for tuition and fees. *

Yes, I agree to register my child for WKA's Kindergarten program and confirm that the information I have provided above is complete and accurate.
Name *

First Name Last Name
Signature *

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Additional Comments:
Should be Empty:

Application for Kindergarten Admission