Whole Kids Academy Kindergarten Admissions Application

PARENT/GUARDIAN CONTACT INFORMATION
Parent/Guardian Contact #1
Name*

PrefixFirst NameLast NameSuffix
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Primary Phone*

Area CodePhone Number
Alternate Phone*

Area CodePhone Number
E-mail*
example@example.com
Parent/Guardian Contact #2
Name

PrefixFirst NameLast NameSuffix
Address

Street Address

Street Address Line 2

CityState

Zip Code
Primary Phone

Area CodePhone Number
Alternate Phone #2

Area CodePhone Number
E-mail
example@example.com
Emergency or Alternate Contact
Name*

PrefixFirst NameLast Name
Relation*
Primary Phone*

Area CodePhone Number
Alternate Phone #1*

Area CodePhone Number
Pickup Authorization

Please list the name/names of all persons authorized to pick up your child.
Name*
Phone Number*

Area CodePhone Number
Name*
Phone Number*

Area CodePhone Number
Name
Phone Number

Area CodePhone Number
Name
Phone Number

Area CodePhone Number

ACADEMIC HISTORY
What is your neighborhood school or which private school do you plan to send your child after WKA?*
Did your child attend preschool at WKA?*

YesNo
Please describe your child's experience and ability level to comprehend and speak Spanish.*
Does your child have any special needs? (academic, nutritional, emotional, social, etc.)*

YesNo
Please describe your child's special needs.*
Academic, nutritional, emotional, social, etc.
Does your child have an Individualized Education Program (IEP)?*

YesNo
Please share more about your child's Individualized Education Program (IEP).*
What are your primary academic goals for your child this school year?*
In what ways will your family plan to support your child's academic goals at home?*
How does your child learn best?*

COMMITMENT ACKNOWLEDGEMENT & SIGNATURE
By signing and completing this admissions application, I confirm my intent for my child to attend WKA's Kindergarten - 3rd grade program for the 2026-27 academic school year, beginning on August 24, 2026 - June 16, 2027 (dates to be confirmed with the 2026-27 School Calendar). Upon acceptance to the program I understand I will have one week to confirm my child's spot and make payment arrangements for tuition and fees. (Registration, books and materials $850, annual tuition is $24,200, with bi-weekly payment options available).*

Yes, I agree to register my child for WKA's Kindergarten - 3rd grade program and confirm that the information I have provided above is complete and accurate.
Name*

First NameLast Name
Signature*

Clear
Additional Comments:
Should be Empty:

Application for K-3 Admission