Rising High Homeschool Academy Application

Rising High Homeschool Academy Application
Parent Information
Full Name (Mother's)*

PrefixFirst NameLast Name
Full Name (Father's)*

First NameLast NameSuffix
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
Mother's Cell Phone Number*

Area CodePhone Number
Father's Cell Phone Number*

Area CodePhone Number
E-mail*
Student Information
Full Name*

First NameLast Name
Date of Birth*

MonthDayYear
Grade Level*
School Previously Attended and Grades*
Reasons for Attending A Home School Program
Can your child work independently?
Does your child have a learning disability or attention deficit?*
If 'Yes", please explain
Has applicant repeated a grade?
If yes, explain
These are extra classes that will be offered. Please place a check in the boxes beside the classes that might interest your child. Your child does not have to be enrolled in the homeschool program to participate in the special classes.
Tell Us About Your Child*
Upload Applicant's Transcript

Upload a File

Cancelof
Upload Recent Photograph of the Applicant
You can upload your child's transcript or mail a copy to the address below, along with the nonrefundable registration fee of $60.00 made payable to: Sondra Anderson, 4960 Hazelwood Drive, Alpharetta, GA 30004
Signature

Clear
Please expect notification of your child's acceptance to RH via phone call or US mail. Also mark your calendar for an information session on July 26th and a parent orientation meeting on August 9th.
For office use only
Registration Payment

PaidNot Paid
Transcript Submitted

YesNo
Signature

YesNo
Date and time of Submission

MonthDayYearHourMinutesAM/PM Option
Should be Empty:

Rising High Homeschool Academy Application

For office use only