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Welcome
Academics
Admissions
Gallery
Extracurricular
Portal Login
Contact
Enrollment Form
School Year
*
Re-Enrollment
New Enrollment
Name
*
First Name
Last Name
Called by
*
Grade
Mailing Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Email
*
Home Phone
(###)
###
####
Sex
*
Birth Date
*
MM
DD
YYYY
Race
US Citizen
*
Yes
No
Father's Information
Father's Name
First Name
Last Name
Father's Employer
Father's Work Phone
(###)
###
####
Father's Cell Phone
(###)
###
####
Mother's Information
Mother's Name
First Name
Last Name
Mother's Employer
Mother's Work Phone
(###)
###
####
Mother's Cell Phone
(###)
###
####
Child’s Living Arrangement
*
Both Parents
Mother
Father
Other
*Name of person authorized to pick up child
*
Emergency Contact
First Name
Last Name
Relationship
*
Phone
*
(###)
###
####
Name of person authorized to pick up child
*
(other than parents)
First Name
Last Name
Relationship
*
Phone
*
(###)
###
####
Physician’s Name
*
Physician’s Phone
*
(###)
###
####
Health Problems/Allergies
*
School Attended Last Year
*
City/State
*
Phone
*
(###)
###
####
Has your child ever been suspended or expelled from school?
Yes
No
Has your child ever failed a grade or been held back?
Yes
No
Has your child ever received any special education services or classroom accommodations?
Yes
No
Has the student ever undergone counseling for discipline, psychological or other reasons?
Yes
No
Brief Description
Church You Now Attend
*
Pastor's Name
*
First Name
Last Name
Phone
(###)
###
####
In making application, I desire for my child to complete the school year 2023-2024. It is also my understanding that the policy of the school is to make no refunds or transfers on registration fees, book fees or first tuition payment. I also give permission for my child to take part in all activities of AIM Academy. I further agree to indemnify and hold AIM Academy harmless for any and all liability that may result from my child participating in all activities of AIM Academy. I have also read and agree with the AIM Academy Handbook, which includes the Statement of Faith. I affirm that all information on this application is true and up to date, and I will notify the school of any changes. I understand that incorrect information may lead to administrative dismissal.
*
I agree to this statement of cooperation
Parent's Signature
First Name
Last Name
Date
MM
DD
YYYY
Thank you!
