Enrollment Application | Rising Warriors Academy

Rising Warriors Enrollment Application

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Student Information

Student Full Name:

Date of Birth:

Age:

Gender:

Male

Female

Grade to be enrolled:

Address:

City:

State:

Zip Code:

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Parent/Guardian Information

Parent/Guardian 1 Name:

Relationship to Student:

Address:

City:

State:

Zip Code:

Phone Number:

Email:

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Parent/Guardian 2 Name:

Relationship to Student:

Address:

City:

State:

Zip Code:

Phone Number:

Email:

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Emergency Contact

Name:

Phone Number:

Relationship to Student:

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Previous School Information

Previous School Name:

Grade Level Last Completed:

Reason for Transfer:

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Medical Information

Primary Doctor’s Name:

Primary Doctor’s Phone Number:

Does the student have any allergies?

Yes

If yes, please specify:

Does the student have any medical conditions or special needs?

Yes

If yes, please specify:

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Academic Information

Desired Grade Level for Enrollment:

Desired Start Date:

Does the student have an IEP or 504 plan?

Yes

Is there any other information that I need to know to help better connect and guide your child?

How did you hear about our school?

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Documentation Required for Enrollment

Please attach the following documents to this application:

Birth Certificate
Proof of Address (Utility Bill, Lease Agreement, etc.)
Immunization Records
Academic Transcripts/Report Cards

THIS IS A REQUIRED FIELD

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