25/26 Student Registration Form

25/26 Student Registration Form
Student's Name

First NameMiddle NameLast Name
Student's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Student's Grade Level for 25/26 School Year
Student Status for 25/26 School Year (check all that apply)

Full-TimePart-TimeHomeschool
Father's Name

First NameLast Name
Father's Phone Number
Father's Email
Father's Address (if different from student)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mother's Name

First NameLast Name
Mother's Phone Number
Mother's Email
Mother's Address (if different from student)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
We intend for our student to attend Union Pointe Academy for the 2025-2026 school year. A $225 non-refundable Registration Fee per student must be returned with this form in order for it to be processed. We cannot guarantee a spot in the class for your
child without payment of the Registration Fee. Payment can be made in the form of cash, check (made out to Union Pointe Academy), or online (https://www.unionpointeacademy.org/payment).
Father's Signature

Clear
Today's Date

MonthDayYear
Mother's Signature

Clear
Today's Date

MonthDayYear
Should be Empty: