Iluminare Academy - Application for Admission

Iluminare Academy - Application for Admission
Thank you for your interest in Illuminare Academy. This application helps us learn about your family and determine if our program is the right fit for your child. Our mission is to provide a Christ-centered, academically rich, and relationally supportive learning environment.

Family Information
Contact Information
Father Name

First NameLast Name
Mother Name

First NameLast Name
Marital Status

SingleMarried
Primary Email Address
example@example.com
Primary Phone Number
Please enter a valid phone number.
Primary Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Church & Faith Background
Name of the church the family is attending
How long have you been attending this church?

More than 3 monthsMore than 6 monthsMore than 12 monthsMore than 2 years

Student Information
Student Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Grade student will enter in the Fall
Gender

MaleFemale
About Your Child
What are your child's strengths, interests, or gifts?
Are there areas where your child may need extra academic, emotional, or behavioral support?
Has your child ever received academic, behavioral, or learning support?

YesNo
Please Explain:
Has your child ever been suspended, expelled, or asked to leave a school?

YesNo
Please Explain:
What are your academic goals for high school?
What are your current or future plans after graduation?
Do you have another student?

Yes, click Next.No, click Submit.

Second Student Information
Student Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Grade student will enter in the Fall
Gender

MaleFemale
About Your Child
What are your child's strengths, interests, or gifts?
Are there areas where your child may need extra academic, emotional, or behavioral support?
Has your child ever received academic, behavioral, or learning support?

YesNo
Please Explain:
Has your child ever been suspended, expelled, or asked to leave a school?

YesNo
Please Explain:
What are your academic goals for high school?
What are your current or future plans after graduation?
Do you have another student?

Yes, click Next.No, click Submit.

Third Student Information
Student Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Grade student will enter in the Fall
Gender

MaleFemale
About Your Child
What are your child's strengths, interests, or gifts?
Are there areas where your child may need extra academic, emotional, or behavioral support?
Has your child ever received academic, behavioral, or learning support?

YesNo
Please Explain:
Has your child ever been suspended, expelled, or asked to leave a school?

YesNo
Please Explain:
What are your academic goals for high school?
What are your current or future plans after graduation?
Do you have another student?

Yes, click Next.No, click Submit.

Fourth Student Information
Student Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Grade student will enter in the Fall
Gender

MaleFemale
About Your Child
What are your child's strengths, interests, or gifts?
Are there areas where your child may need extra academic, emotional, or behavioral support?
Has your child ever received academic, behavioral, or learning support?

YesNo
Please Explain:
Has your child ever been suspended, expelled, or asked to leave a school?

YesNo
Please Explain:
What are your academic goals for high school?
What are your current or future plans after graduation?
If you need to submit an application for additional students, please submit this and fill in the form again.
Should be Empty:

Family Information