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Heritage Academy Enrollment Form

* indicates a required answer.

1.*

School Year

2. *

Family Name

3. *

Father's Name

4. *

Mother's Name

5. *

Address

6. *

City

7. *

State

8. *

Zip

9. *

County

10. *

Phone

11. *

Cell phone

12. *

Email

13. *

Church affiliation

14. *

Pastoral reference and phone number

15. *

Years of homeschooling

16. 

List all K-8 students (Full name, Age, Date of Birth, and Grade)

17. 

List all High School Students (Full name, Age, Date of Birth, and Grade)

18. 

New Families Only:  Name, address, phone and fax number of previous school

19.*

I have read and reviewed all school policies.  I realize that it is my responsibility to abide by all state laws regarding all home education and keep copies of all legal documents.

 (1 required)
Yes