Ivy League Academy Enrollment Application
| Age |
Date of Birth |
Home Phone # |
| Mother's Name |
Home Phone # |
| Employer |
Occupation |
| Business Phone # |
Social Security # |
| Father's Name |
Home Phone # |
| Employer |
Occupation |
| Business Phone # |
Social Security # |
| Are parents divorced or separated? |
Is child adopted? |
| Person(s) with legal custody |
Relationship |
| Others in household relationship |
| |
| Person(s) authorized to pick up child |
| |
If a parent is not authorized, a certified true copy of the court order must be attached.
| How did you hear of Ivy League Academy? |
| Why was this school chosen? |
| |
| Other schools attended (including preschool) |
| |
| Academic grades have been |
above average |
average |
below average |
| Has the child ever failed or been retained? |
| Number of absences last year |
Reason |
| Has the child ever been denied admission to a school? |
If yes, why? |
| Has the student ever been suspended or expelled? |
If yes, why? |
| Church affiliation of parents/guardians (if any) |
It is expected that your child will attend all field trips. Should you not wish your child to attend a particular field trip, you will be expected to make arrangements for care that day at no reduction in the tuition fee.
THE PARENT/GUARDIAN GIVES PERMISSION TO IVY LEAGUE ACADEMY TO TAKE THE CHILD/CHILDREN ON ALL FIELD TRIPS.
Emergency Information:
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