Apply to AATA
Thank you for your interest in the Appalachian Academy of Therapeutic Arts!
Child's Name
*
First Name
Last Name
Child's DOB
*
Child's Gender
*
Please Select
Girl
Boy
Year applying for
*
Spring Semester 2025
Academic Year 25-26
Class applying for
*
Early Childhood/Kinder (Ages 2-5)
Lower Grades (Ages 6-8.5)
Upper Grades (Ages 8.5-11)
Middle School (Ages 12-14.5)
Early High School (Ages 14.5-16)
Other (Please Explain below)
Parent/Guardian Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Parent/Guardian Name
First Name
Last Name
Email
example@example.com
Phone Number
-
Area Code
Phone Number
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Child's Age at Application & Grade
*
Child's Prior Education (Please list any/all Schools, Programs and or Home School experience)
*
Why are you interested in your child attending AATA?
*
Are there any siblings to the applying child(ren)?
*
Special Accommodations
*
Allergies, Dietary, Learning
Is there any additional information you'd like to provide at this time?
*
How did you hear about us?
*
Signature
*
Donation Application Fee
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( X )
USD
50.00
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
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