2024-2025 Student Application
Scholar General Information
Applying Student's Name
*
First Name
Middle Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
What grade will your student be entering in the upcoming 2024-2025 school year?
*
Kindergarten (For eligibility, your scholar's birthday should be before September 1, 2019)
1st grade
2nd grade
3rd grade
4th grade
Student's Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Neighborhood School District (ex: DeKalb County)
*
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Parent/ Guardian General Information
Parent/Guardian Name 1:
*
First Name
Last Name
Phone Number
Relationship to Scholar
*
Please Select
Mom
Dad
Grandmother
Grandfather
Guardian
Aunt
Uncle
Please select 1 option
Email
*
example@example.com
Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent/Guardian Name 2:
First Name
Last Name
Phone Number
Relationship to Scholar
Please Select
Mom
Dad
Grandmother
Grandfather
Guardian
Please select 1 option
Email
example@example.com
Home Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Does the scholar have a sibling eligible to attend PEACE Academy (K-4 in Fall 2023)?
*
Yes
No
(If you selected yes to the above question, please complete this section)- Sibling 1 Name
Sibling 1 Grade
Kindergarten
1st grade
2nd grade
3rd grade
4th grade
(If the scholar has an additional sibling that is eligible to attend PEACE Academy, please complete this section)- Sibling 2 Name
Sibling 2 Grade
Kindergarten
1st grade
2nd grade
3rd grade
4th grade
Do the scholar and the sibling(s) live together at the same address?
Yes
No
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Emergency Contact General Information
Emergency Contact 1 Name
*
First Name
Last Name
Primary Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Relationship to Scholar
*
Please Select
Mom
Dad
Grandmother
Grandfather
Guardian
Aunt
Uncle
Please select 1 option
Emergency Contact 2 Name
First Name
Last Name
Primary Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Relationship to Scholar
Please Select
Mom
Dad
Grandmother
Grandfather
Guardian
Aunt
Uncle
Please select 1 option
Email
example@example.com
Emergency Contact 3 Name
First Name
Last Name
Relationship to Scholar
Please Select
Mom
Dad
Grandmother
Grandfather
Guardian
Aunt
Uncle
Please select 1 option
Primary Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
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Additional Information
Does either parent/guardian serve on the board for PEACE Academy Charter?
*
Yes
No
(If yes, please enter the Board Member's name)
Do you currently have a student(s) that attends PEACE Academy Charter?
*
Yes
No
(If yes, please enter their names here)
Where did you learn about the PEACE Student Enrollment Application?
*
PEACE Board Member
PEACE Staff Member
PEACE Event
PEACE Social Media
Other
Please enter the specific name or platform from your selection above:
*
Signature
Submit
Should be Empty: