GEM School Application

GEM School Application

Admission is subject to confirmation after the parent and student interview.
School Year
Registering For:
Is the child you are applying for TEFA Approved?
1 - Student's Full Name

First NameLast Name
Student Email
example@example.com
Gender
2 - Student's Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate of Birth
3 - Grade Level (2026-2027)

PARENT INFORMATION
Mother Full Name

First NameLast Name
Mother Email
example@example.com
Mother Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Father Full Name

First NameLast Name
Father Email
example@example.com
Father Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Home Address

Street Address

Street Address Line 2

CityState

Zip Code

Payment

If you are TEFA approved, please continue to the next page

GEM School Application Fee

$150.00

Enter coupon

Debit or Credit Card
Credit Card Number	Security Code
Expiration Month	Expiration Year

Any Comments
Enrollment Disclosures

Please review and sign
Liability Waiver
Enrollment Policy
Program & Vendor Disclosure:
Refund Policy:
Late Pickup Policy:
Termination of Enrollment:
By signing below, i agree to the above enrollment disclosure
Date of Consent

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate