New Student Online Application

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Email: *
Student's Name: * First Last
Student's Nickname:
Home Address: *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Gender: *
Birth Date: * MM / DD / YYYY
Birth Place: *
Race/Ethnicity:
Please note: Race/Ethnicity is for statistical and state reporting purposes only. The Rock Academy admits students of any race, color, and national or ethnic origin.
US Citizen: *
Yes No
Social Security Number: (optional)
What church is your family currently attending? *
Please note: The Rock Academy admits students of all faiths. However, by enrolling your student your student at The Rock Academy, you are agreeing that you child respect Christian teaching practices without disruption in a spirit of unity, harmony and love.
School year: (select one)
Note:

If applying for Kindergarten, it is best if your child turns 5 prior to September 1, however, no child will be considered who turns 5 after December 2.
Applying for:(select one) *
If Preschool, how old is your child?
SCHOOL HISTORY:
Present School:
Current Grade:
School Phone: ### - ### - ####
Public Independent
School Address:
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Teacher's Name:
Name of principal or guidance counselor:
Other Schools attended:
Has student ever been tested for a learning disability:
Yes No
If yes, please explain:
Has your child every repeated a grade:
Yes No
If yes, please explain:
Has your child ever been suspended or expelled:
Yes No
If yes, please explain:
Please list all medical, psychological, learning or other difficulties that you are aware of:
Kindergarten Students Only:
Did student attend preschool:
Yes No
MOTHER/GUARDIAN:
Mother's/Guardian's Name: * Title First Last Suffix
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Email:
Phone Number (primary): ### - ### - ####
Phone Number Type (primary)
Phone Number (secondary): ### - ### - ####
Phone Number Type (secondary)
Occupation/Name of Company
Business Address:
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Educational Background:
FATHER/GUARDIAN:
Father's/Guardian's Name: * Title First Last Suffix
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Email:
Phone Number (primary): ### - ### - ####
Phone Number Type (primary):
Phone Number (secondary): ### - ### - ####
Phone Number Type (secondary):
Occupation/Name of Company:
Business Address:
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Educational Background:
PARENTAL CIRCUMSTANCES:
With whom is student currently living: *
Who is the student's legal guardian: *
Please mark all appropiate boxes: *
Parents Married Parents Unmarried Parents Divorced Parents Separated Father Remarried Mother Remarried Father Deceased Mother Deceased
Please note: If the student does not reside with both parents listed on the student's birth certificate, the parent or legal guardian must provide documentation of custody by an appropriate state agency. If a restraining order is in place concerning any student, documentation is required for the health and welfare of the student body.
FINAL QUESTIONS:
I/We plan to apply for tuition assistance:
Yes No
How did you learn about The Rock Academy:
Why do you want to enroll your student in The Rock Academy:
Parental Commitment

The Rock Academy is founded on the Biblical principle that parents, not the school, are responsible before God to trainup their children. The faculty and staff of the Rock Academy desire to come alongside parents and help them infulfilling their God-given responsibility. The school is to be an extension of the Christian home, to reinforce moral and ethical standings in light of God’s Word. In that light, as parents, please initial the following commitments for enrollment at the Rock Academy.

• We, as parents who are accepting the challenge to “train up a child in the way he should go,” do state that this training will be carried on in the home. We shall place our trust in the Rock Academy to extend that training more completely.
• We recognize that it is a privilege for our child to attend this school and that the school reserves the right to dismiss any student who does not cooperate with the ideals and educational process of the school
(Ephesians 5:15-16).
• We will provide spiritual guidance through regular church attendance, prayer, and Bible reading at home
(Proverbs 22:6).
• We realize that building a strong relationship with our child’s teacher to aid in the training of our child is as much our responsibility as it is the school’s responsibility. We will endeavor to maintain open communication with the teacher. We will be faithful to read and follow through with all correspondence sent from the teacher
(Ephesians 4:3).
• We will cooperate fully with the school. We pledge our loyalty to the aims and ideals of the school and will be careful to support teachers, school, and church policies in front of our children and others. We will bring any and all questions and criticisms directly to the appropriate staff member so that they may be properly resolved with discretion, quietly and respectfully and/or considered by those in authority (Matthew 18:15-20).
• We will support the school’s discipline plan and give the teachers and administrators full discretion in the discipline of our child. Detention may be used for various offenses and non-completion of school and homework (Proverbs 3:11).
• We will make sure that our child attends school daily and on time (Proverbs 13:4).
• We agree to uphold and support high academic standards by providing a place at home to study and to encourage the completion of homework assignments.
• We agree to pay reasonable assessments to cover damage to the school or personal property of others caused by our child(ren).
• We agree to attend the two mandatory parental orientation/workshops.
• We agree to follow the student and parent handbooks and abide by the stated guidelines.
• We agree to forfeit the privilege of our child(ren)attending school should we fail to comply with the established regulations, discipline and financial obligation of the Rock Academy.
I/We have read and agree to the terms on the Parental Commitment: (please type your name) *
The Rock Academy admits students of any race, color, and national or ethnic origin.

Please take a moment and double check your anwers before pressing the submit button.
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New Student Online Application

Note:

SCHOOL HISTORY:

MOTHER/GUARDIAN:

FATHER/GUARDIAN:

PARENTAL CIRCUMSTANCES:

FINAL QUESTIONS:

Parental Commitment