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  • GLOBAL PURPOSE ACADEMY
    (GPA) REGISTRATION / ENROLLMENT FORM
     
  • ALL FIELDS MUST BE COMPLETED. PLEASE DO NOT LEAVE ANYTHING BLANK. IF NOT APPLICABLE, PLEASE WRITE "N/A".
     
  • CHILD'S INFORMATION
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  • PARENT(S) / GUARDIAN(S) INFORMATION
  • MOTHER / GUARDIAN
  • MOTHER'S / GUARDIAN'S WORK INFORMATION
  • FATHER
  • FATHER'S WORK INFORMATION
  • OTHERS AUTHORIZED TO DROP OFF / PICK UP CHILD FROM GPA
     
  • Primary Contact
  • Secondary Contact
  • SPECIAL CONTACT INSTRUCTIONS
  • OTHER EMERGENCY CONTACT(In case of illness or other emergency if parents cannot be reached)
  • Primary Contact
  • Secondary Contact
  • CHILD'S PEDIATRICIAN OR SOURCE OF HEALTH CARE
  • MEDICAL AUTHORIZATION
  • I give Global Purpose Academy permission to apply one or more of the following topical ointments / preparations to my child(ren) in accordance with the directions on the label of the container:
     

  • MEDICAL EMERGENCY STATEMENT
  • I hearby give my consent to Global Purpose Academy (GPA) to authorize medical treatment for my child(ren) should it be necessary while my child(ern) is/are in GPA's care and GPA is unable to contact me immediately. I give permission for GPA to take my child(ren) to a hospital when I cannot be reached to secure medical attention and care for my child(ren) as may be necessary. I shall assume responsibility for payment for medical services.
     
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  • NOTICE OF NO LIABILITY INSURANCE & ACKNOWLEDGEMENT
  • I understand that I am being informed by signing this acknowledgment that GPA does not carry liability insurance sufficient to protect my child(ren) in the event of an injury, etc.
     
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  • ON-SITE CONSENT
  • I hearby give Global Purpose Academy (GPA) permission to allow my child(ren) to participate in on-site field play/activities (pavilion, black top, open field, etc.) at GPA.
     
  • OFF-SITE CONSENT
  • I hearby give Global Purpose Academy permission to take my child(ren) on excursions that might include the following type of activities: riding in vehicle (car, van or bus) and field-trips (zoo, park, restaurant, aquarium, etc.)
     
  • I understand that GPA will take every precaution (on-site and/or off-site) and care to insure my child's safety. Adults will provide proper supervision and will exercise every precaution to avoid accidents. I am aware of the risks associated with such activities, I agree to hold Global Purpose Academy, its officers, faculty and employees harmless against any liability arising as a result of his/her participation in these activities. If illness or injury should occur during his/her participation in these activities, I authorize medical treatment at an appropriate medical facility. I understand that a reasonable attempt to be contacted will be made prior to such medical treatment.
     
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  • CONSENT TO USE YOUR CHILD'S IMAGE
  • We may take photographs and/or videos of children at our school. We may use these images in GPA's printed publications, as well as on our website, e-newsletter and social media such as Facebook. We may also make video or webcam recordings for conferences, monitoring or other educational use. We need your permission before we can photograph or make any recordings of your child for promotional and/or educational purposes. Please sign below if you grant us permission to take photos / videos of your child.
     
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  • CONSENT TO TEXT MESSAGE
  • For the purpose of quick communication, permission is requested for GPA teachers and staff to use text messaging as a communication tool for school information. GPA will only text important information related to the school and/or your child's behavior and class work. As would be the case with any texting, standard rates for texting would apply to any texts sent and would be the responsibility of the students and families.  I give permission for GPA teachers and staff to use text messaging to send quick communication regarding school information to the following numbers. I understand and agree that GPA will not pay for any costs to students or Parents/Guardians associated with the sending or reception of messages to or from GPA teachers and staff.
     
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  • CHILD'S SCHEDULE & INTERESTS[the following information will help GPA understand & care for your child(ren)]
     
  • Toilet & Independence

  • Nap / Rest Habits
  • Student Information
  • Please upload any known allergy, medical and/or behavior diagnosis / reports.
     
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  •  IMMUNIZATION & HEALTH FORMS
     
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  • TUITION PREFERENCE
  • TUITION PROGRAMS
  • Preschool Program: "Chrysalis" (age 3 - 4)
  • Pre-Kindergarten - Kindergarten: "Butterflies" (ages 4 - 5)
     
  • ELEMENTARY AGE (when public/private schools are not in session)
    1st - 2nd grade: "Explorers: (ages 6 - 7)
    3rd - 4th grade: "Innovators" (ages 8 - 9)
    5th - 6th grade: "Scholars" (ages 10 - 11)
     
  • Expected First Day of School
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  • APPLICATION FEE (non-refundable)
  • REGISTRATION FEE (non-refundable)
  • UNIFORM PURCHASE
  • Purchase your child's uniform by clicking on the following link: LANDS' END: School Number 900162207
    Please note: GPA branded uniform shirts are required during the regular academic school year. Students must also wear their their uniform on field trips, picture day, during events and project presentations.
    GPA uniform: GPA logo polo shirt (purchase via Lands' End), solid colored khaki pants / shorts / dress or skirt (purchase at any store), closed toe shoes (no sandals or light up or character shoes).  GPA's official uniform is the teal GPA branded shirt with khaki pants.  
     
  • NAP MAT
  • Parents with children ages 3 – 4 years must provide a nap mat (blanket w/pillow). GPA prefers the Wildkin brand because it is the safest nap mat on the market. It is toxin free and naturally flame retardant. Wildkin Nap Mats are never treated with chemicals and are rigorously tested to ensure that all parts are lead, BPA, PVC and phthalate free. To purchase your child's nap mat, please click on the following link: WILDKIN NAP MATS
     
    Please note: You are not required to purchase the Wildkin brand; you may purchase another brand of nap mat or simply bring your child’s favorite blanket or pillow from your home. Please ensure that you label your child’s belongings with their full name.
     
  • TUITION / FEE STATEMENT
  • Tuition is assessed on an annual basis. To assist our parents we have provided several payment preferences (weekly, biweekly, monthly, annually, etc.). Tuition payments are due the first day of service (based on your payment preference) with no deductions for any absences, suspensions or holidays. Tuition discount for sibling enrollment is: 10%. (Penalty Fees: If tuition is not paid on the day it is due, a late fee of $15 will be added to the tuition each day it is late. There is a $2/minute (per child) late fee to be paid upon arrival. A $35 fee will be charged for a check returned for insufficient funds.)
  • WRITTEN NOTICE
     
  • To facilitate planning and budgeting, please provide us with a written notice (via e-mail) of your scheduled vacation days and/or change in enrollment status (at least 30 days prior). We would greatly appreciate your advance notice as it is critical to the sustainability and effectiveness of our school and programs.  THANK YOU.

  • I have read and fully understand the tuition and fee statement.
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  • STUDENT REFERRAL PROGRAM
  • GPA has an excellent Student Referral Program. After your referral has attended GPA for 90 days (3 months), you will receive a $250 tuition credit toward your next monthly tuition. 

    Referral Program Details: 1) Provide the contact information of your referral 2) Your referral must include your name on the referral and/or registration form 3) The new student must be active and attending GPA for at least 90 days (3 months) 4) You will receive a $250 tuition credit (after referral has been at GPA for 3 months) To facilitate referrals, we will provide you with promotional materials (brochures and cards). You may also refer people to GPA's website and GPA's Facebook page. Prospective parents/students may schedule a 30 minute appointment to meet with me and tour the school on Monday - Friday between the hours of 9am - 11am and again from 4pm - 6pm.

  • REFERRAL
  • GPA's SOCIAL MEDIA
    Like / Subscribe / Follow & SHARE
  • HOW DID YOU HEAR ABOUT US?

  • WHY DID YOU CHOOSE TO REGISTER YOUR CHILD WITH US?

  • SIGNATURE
  • I have completed my child's registration application and answered all of the questions truthfully.  I will read and sign the Parent Handbook within 7 days of the submission of my child's registration form.  
    (You may use your finger or mouse to sign your name).
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  • THANK YOU for choosing Global Purpose Academy to care for and educate your child to achieve excellence in everything and explore their purpose...
     
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