25/26 Student Application Form

2025/2026 Student Application

Welcome to Berea Academy!
Please fill out the application to the best of your knowledge. No information provided leads to automatic acceptance or disqualification. All applicants meet with members of administration at Berea Academy Saint Louis before acceptance to the program. The information you provide contributes to understanding your needs and goals in joining Berea Academy. For more information, view our Admission Policy at our website, bereaacademystl.org
Primary Adress*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Student*

First NameLast Name
Student's Date of Birth

MonthDayYear
Date
Student's Age on August 31, 2025
Gender*
How will you be paying the application fee?

I will bring my check (made out to Berea Academy) in person to my Application Meeting or mail it to 9820 East Watson Rd. 63126I will use a credit/debit card to pay online when I receive my invoice which will increase my $25 fee by 3%

Primary Homeschool Manager

Contact Information
Primary Homeschool Manager: Family Member or Friend

First NameLast Name
Primary Homeschool Manager: Family or Friend

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Primary Homeschool Manager: Family or Friend

Area CodePhone Number
Primary Homeschool Manager: Family or Friend Email
example@example.com
Briefly explain the relationship between your student and their homeschool manager:

Student's Past Education Experience
Brief Summary of Previous Education Experience*
Have you been homeschooling for the most recent three or more years?*

YesNoMy student is 7 years old or younger, and has not attended a traditional school.
Please list the most recently attended public or private school and your reason for leaving:
Are there additional school programs your student has previously attended?*
Does your family participate in a Co-op or learning center? Please list other organizations you participate with currently or have participated with in the last three years. *
Do we have your permission to contact organizations you have previously been involved with?*

YesNoWe have not been involved with other Co-ops or learning centers.
If you answered No, please explain your response:

References
List two references below;

If you have a relationship with a member of Berea Academy's staff, teachers, or Board of Directors, please list those names first. Use only individuals who have been active in your student's or family's life in the last 2 years.
Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Email*
example@example.com
Briefly describe your relationship to the individual listed: *
If you know the individual's preferred method of contact, please indicate below.

Phone callText MessageEmailOther
Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Email*
example@example.com
If you know the individual's preferred method of contact, please indicate below.

Phone callText MessageEmailOther
Briefly describe your relationship to the individual listed: *

Submitting the Form
For more information on our application process, code of conduct, class availability or other student related questions, be sure to view our website at www.bereaacademystl.org
SIGNATURE

By signing below, I affirm that the information provided on this application is accurate and complete. We agree to comply with the code of conduct set at Berea Academy. I understand that Berea Academy is only able to admit students whose needs it has the resources to meet. I understand that the required Student Application fee is non-refundable.
Signature
Should be Empty:

2025/2026 Student Application