Academy of Scholars Admissions Forms

Child's Name*

First NameLast Name

Age*

Gender*

MaleFemale

Ethnicity (Check One)

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Parent/Guardian Information

Name*

First NameLast Name

Name

First NameLast Name

Relationship

Home Number*

Area CodePhone Number

Work Number*

Area CodePhone Number

Work Extention Number*

Cell Number

Area CodePhone Number

E-mail*

Emergency Information

Emergency Contact's Name*

First NameLast Name

Relationship*

Phone Number*

Area CodePhone Number

Alt. Phone Number

Area CodePhone Number

Does your child have any allergies, chronic illness, or medical conditions? If yes, please describe.*

EMERGENCY HOSPITAL CONSENTEMERGENCY HOSPITAL CONSENT

I authorize Academy of Scholars, Inc. or its representatives to call 911 and summon emergency medical help when in the judgment of said personnel if it is in the best interest of my child. I further authorize responding paramedics to transport my child to the nearest medical facility which will be in the opinion of the paramedics on scene. If medical care is necessary, I authorize treatment of my child. I also agree to pay any medical cost associated with the transportation and/or treatment of my child.

I, Hereby*

I agreeI disagree

Medical Release and Authorization

As Parent and/or Guardian of the named child, I understand that every attempt will be made by the attending staff contact me in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach me.

Permission is also granted to Academy of Scholars and its affiliates including Teachers, Staff, Directors, Coaches, and Team Parents to provide the needed emergency treatment prior to the child’s admission to the medical facility.

Release authorized on the dates and/or duration of the registered season.

This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named minor child, in my absence.

I agreeI disagree

PRIVATE SCHOOL TUITION & FEE SCHEEDULE

2022 – 2023

A $50 non-refundable application fee and a $100 non-refundable registration fee will be due when contract is signed.

COMBINED TUITION & FEES BY GRADE LEVEL

GRADES ANNUAL PAY 10-PAYMENTS ONE-FOURTH PAY

Kindergarten $6,100 $610 $1,525.00

ELEMENTARY $7, 850 $785 $1,962.50

(1^st - 5^th)

MIDDLE $9,500 $950 $2,375.00

(6^th – 8^th)

HIGH $10,310 $1031 $2,577.50

(9^th-11^th)

TUITION PAYMENT OPTIONS:

1. Payment in full (due with contract)

2. 10 Month Pay (ten equal payments paid from August 2022 – May 2023)

3. One-Fourth Pay (three equal payments paid August 2022, November 2022, February 2023 & May 2023)

4. Step-Up, McKay and PLSA Scholarships are accepted. Annual fees will be paid by scholarship disbursements. Fees not covered by scholarship payments can be paid in four or ten equal payments.

(Payments made after the 5^th of the month will be assessed a fee of $50)

UNIFORM FEE:

ANNUAL PAY 2-PAYMENTS

$300 $150

A.M. & P.M. CARE:

BEFORE SCHOOL CARE HOURS 7:15 AM – 8:20 AM

AFTER SCHOOL CARE HOURS 3:45 PM – 5:45 PM

ANNUAL PAY 10-PAYMENTS ONE- FOURTH PAY

A.M. CARE $1000 $100 $250.00

P.M. CARE $2500 $250 $625.00

BOTH $3000 $300 $750.00

DROP-IN SESSION A.M. - $30/SESSION

DROP-IN SESSION P.M. - $60/SESSION

ADDITIONAL FEES:

End of the Year Exam $100

Field trips (varies) $15 - $35 per trip

Textbooks $50 - $100 annual purchase rate

IPADS $50 - $100 annual rental rate

Yearbooks - $20 - $35

*TUTORING IS FREE*

MULTIPLE CHILD DISCOUNT: Discount can only be deducted from registration fee during completion of contract.

Two Kids - $100 OFF

Three Kids - $150 OFF

Four or More - $200 OFF

Click to edit*

I agreeI disagree

DISCIPLINE CONTRACT

To Whom It May Concern:

I, the undersigned, agree that attending Academy of Scholars, Inc. is a privilege and I further agree that my child’s well-being and education is top priority to me.

Being that I am a dedicated parent, I want only the best for my child and I am in agreement with the school’s policy concerning discipline.

I agree to the no referral/no suspension policy of the school and I also agree with having the school’s administrators, faculty and/or staff contact me by phone and/or by email if my child, is behaving in a manner that is unsatisfactory.

Please feel free to contact me by phone at or via email between the hours of 8:30 AM – 7:00 PM.

I, am a student at Academy of Scholars, Inc., and it is a privilege to attend this school.

I will conduct myself according to the rules and regulations set forth at Academy of Scholars, Inc. and I am aware of the consequences if I decide to act in a manner that is unacceptable.

Although I will not be suspended or given a referral, I do not want to interrupt my parent/guardian(s) day with my lack of respect for authority or my classmates.

Click to edit*

I agreeI disagree

Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

Parent/Guardian Signature*

The Academy of Scholars Enrollment Agreement