GPCA 24/25 Application

GPCA Application

2024/25 School Year
Tuition & Fees Schedule
Student Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Age*
Student Social Security #
Gender*

MaleFemale
With whom does the student live?*
Student's 2024/25 School Year Grade Level*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
School Last Attended
Previous School Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian's Information
Parent/Guardian's Name - Primary*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Parent/Guardian's Name - Secondary

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
In case of emergency, who will be notified? Please answer the fields below:
Emergency Contact Person*

First NameLast Name
Emergency Phone Number*
Please enter a valid phone number.
Student Behavior
Does your student have temper tantrums or otherwise lose control?*

NoYes (Please explain when this happens.)
List any concerns you have about your student's behavior
Kindergarten History
Has your child been in preschool?

NoYes (List when and where.)
Does your child speak in sentences?

NoYes
Can others understand what your child says?

NoYes
Are there any problems with your child's speech?

NoYes
Does your child play well with other children?

NoYes
How often does your child play with other children his/her age?
Family History
Is there anyone in your household with a physical condition that required medical treatment or medication?

NoYes
Is there anyone in your household who has participated in counseling or mental health services?

NoYes
Have you or a family member been a victim of violence?

NoYes
Have you or a family member ever received treatment for substance abuse?

NoYes
Is there anyone in the family in jail or on probation (current or past)?

NoYes
Does either parent have difficulty reading or did either have learning problems in school?*

NoYes
What is the primary language spoken at home?*

EnglishSpanishOther
Please list any other family concerns that you think we should know about:
File Upload

Colored ID Picture, birth certificate, report card from the previous school, immunization record, and a letter of recommendation.
Upload
Health History
If the student has any allergies, please list them down below:
Does the student currently taking any medications? If yes, please list them down below:
Was the student previously hospitalized or undergo any surgery?
Does the student have any medical conditions that you would like to declare?
Does your student use any medical device?
Reminders
TEST. The school will require new students or a transferee to take a math and language test to see where they place and their levels.

INTERVIEW. The school admin will conduct an interview with the student and parents/guardians prior to admittance.

REQUIREMENTS. It is important to pass and complete all requirements before school starts. Failure to do so may delay the student from coming to school.

BEHAVIOR. A recommendation letter is required in order to get admitted to this school. This could be from a pastor, teacher, or authority figure.
Enrollment Form and Signature
Date Signed*

MonthDayYear
Date
Parent/Guardian Signature*

Clear
Print Name*

First NameLast Name
Should be Empty:

GPCA Application

Tuition & Fees Schedule

Parent/Guardian's Information

Student Behavior

Kindergarten History

Family History

File Upload

Health History

Reminders

Enrollment Form and Signature