HIGHER LIFE ACADEMY

ACADEMIC YEAR
1. STUDENT INFORMATION
Student full legal name

First NameLast Name
Preferred name
Date of birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Grade applying for
Gender
Home address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Allergies or medical conditions
Health card number (if required)
Special learning needs
2. PARENT/GUARDIAN INFORMATION
Parent/guardian name

First NameLast Name
Phone number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Occupation
Second parent/guardian name

First NameLast Name
Phone number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Occupation
*Emergency contact

Name/RelationPhone Number
3. CHURCH & FAITH INFORMATION
Home church
Pastor's name
Church attendance frequency
Child's commitment to Christ
Water baptized
Reason for seeking Christian education
4. ACADEMIC BACKGROUND
Previous school
Last grade completed
Academic strengths
Areas needing support
Previously suspension or expulsion
If yes, please explain
5. FAMILY ALIGNMENT & EXPECTATIONS
Why is this academy a good fit for your family?
Education goals for your child
6. FAMILY INVOLVEMENT & VOLUNTEER INTEREST
Interest in volunteering
7. TUITION, CURRICULUM PAYMENTS & FINANCIAL AGREEMENT
Payment plan selected
Monthly tuition payments are $150, and due the 20th of every month ($100 for parents that volunteer).
They are to be sent via e-transfer and clearly identified in message as: ACADEMY. Email to be sent to: hlcc@live.ca
Curriculum purchasing options
8. MEDICAL & MEDIA RELEASE
Emergency medical authorization
Photo/media permission
9. APPLICATION COST AGREEMENT
Upon submission of application, a payment of $50 per child required. The full amount will be deducted from the August curriculum purchase.
10. HIGHER LIFE ACADEMY ACKNOWLEDGMENTS
We acknowledge that we have read and reviewed the following
11. PROVINCIAL REQUIREMENTS
Parents are responsible to register their students with their province upon homeschooling. Please check with the Ministry of Education for details.
SIGNATURES
Parent/guardian signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit year
Parent/guardian signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Student signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

1. STUDENT INFORMATION

2. PARENT/GUARDIAN INFORMATION

3. CHURCH & FAITH INFORMATION

4. ACADEMIC BACKGROUND

5. FAMILY ALIGNMENT & EXPECTATIONS

6. FAMILY INVOLVEMENT & VOLUNTEER INTEREST

7. TUITION, CURRICULUM PAYMENTS & FINANCIAL AGREEMENT

8. MEDICAL & MEDIA RELEASE

9. APPLICATION COST AGREEMENT

10. HIGHER LIFE ACADEMY ACKNOWLEDGMENTS

11. PROVINCIAL REQUIREMENTS

SIGNATURES