The Choice Academy: Application Form

THE CHOICE ACADEMY SCHOOL APPLICATION FORM

Thank you for choosing The Choice Academy for your child’s education. We are excited to partner with you to provide a nurturing and academically enriching environment.

Please take a few moments to carefully complete this registration form to ensure we have the most accurate and up-to-date information for your child. This form includes important sections on parent involvement, fundraising participation, and media consent, so please review each section thoroughly before submitting.

Once you have completed the form please prepare the following hardcopy documents for submission for enrolment:

1. 2 passport-sized photos

2. Copy of birth certificate (take along original for verification)

3. Last 2 school reports

4. Learning evaluations (where applicable)

5. Completed medical forms

6. Copy of immunization records

Best regards,

The Choice Academy Team
The Choice Academy: School Registration

“Nurturing Minds, Shaping Futures"
If you have multiple children attending, please complete a separate form for each child.
Student Information
First Name
Last Name
Gender
Birth Date

MonthDayYear
Last grade completed?
Last School Attended?
What Grade level are you registering this child for?
Does your child have any special learning needs, diagnosis or require behavioral support?
Has your child ever been referred for a psychoeducational assessment (learning evaluation)
Do you have any particular need/expectation or accommodation that you would hope we can provide?
Please elaborate in details
Do you have a report from a learning evaluation?
Will your child need after-care services?
Please note that an additional fee applies for after-care services.
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Doctors Name

First NameLast Name
Doctors Phone Number

Area CodePhone Number
Parent/Guardian Information
Legal Guardian

First NameLast Name
Mother's Name

First NameLast Name
Cell

Area CodePhone Number
Work

Area CodePhone Number
E-mail
Address - Same As Child? If No, please provide
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Mother's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Father's Name

First NameLast Name
Cell

Area CodePhone Number
E-mail
Church Information

OPTIONAL
Church Name
Pastor Name

First NameLast Name
Church Phone

Area CodePhone Number
Pastor Email
example@example.com
Other Information
Is your child immunized?
Does your child have any allergies?
If yes, please list, including any food or drug allergies.
Does your child have any medical conditions?
Yes or No?
Does your child require any medication? If yes, please list these medications.
Do you authorize us to administer the medications listed above?
Please list the people authorized to pick up your child.
Does your child have any siblings?
If yes, what is their age(s)?
Comments
Parent Involvement & Fundraising Participation
At The Choice Academy, we encourage parents to be actively involved in their child’s education. Please take a moment to indicate how you would like to participate in school activities
Would you be interested in serving as a Parent Representative for your child’s class?
Would you like to participate in classroom involvement activities (reading to the class, attending field trips, small group activities, morning duty, etc.)?
Would you be willing to assist with at least one fundraising event during the academic year?
Other ways I would like to get involved (please specify):
Do you approve or decline permission for your child to be featured on the school's social media platforms and website?

We are enhancing our social media presence and school website to support fundraising efforts and sponsorship opportunities, which will help bring additional programs to the school. As part of these efforts, certain school events may be broadcast or require media coverage based on sponsorship agreements.

Please select one of the options below:

Disclaimer: By selecting "Decline," you acknowledge that your child may not be able to participate in certain events that require media coverage as part of sponsorship agreements.
Do you approve or decline permission for your child to be featured on the school's social media platforms and website?
Emergency Contact - Other than Parent/Guardian

Please provide or update the information for the individual authorized to pick up the children from school.
Full Name

First NameLast Name
Relationship
Cell

Area CodePhone Number
Acknowledgment of Form Submission

We acknowledge the successful submission of your form. Thank you for completing the required documentation. Your cooperation in keeping this information up to date is greatly appreciated, as it helps us maintain effective communication and ensure the best experience for you and your child.

If there are any further steps or additional information needed, we will contact you promptly.

Thank you again for your timely submission.
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
NAME OF PARENT COMPLETING
SIGNATURE OF PARENT
Should be Empty:

The Choice Academy: School Registration

Student Information

Parent/Guardian Information

Church Information

Other Information

Parent Involvement & Fundraising Participation

Emergency Contact - Other than Parent/Guardian