Enrollment Application

Enrollment Term

Will the student need financial aid/scholarship for tuition?

Yes

No

Student Information

Student Full Name (First & Last)

Student Email

Birthday

Month

Day

Year

Grade Level

Does the student have a special schedule (Student Athlete/Performing Arts, Military, Other travel)?

Yes

No

Live Outside the US.

Yes

No

Student Time Zone

Previous School

Former School Name

Former School Address

School District

Will student records need to be requested from the previous school?

Yes

No

Student Support Services

Does student have an IEP or 504 Plan?

No

Yes

Is Student ELL?

No

Yes

List or write out any learning concerns.

Academic Documents

Select the records you will upload

Report Card

Unofficial Transcript

Current IEP/504 Plan

Behavior Intervention Plan (if applicable)

Psychological evaluation (optional)

Standardized Test Scores (optional)

Proof of Student Identity and Age (Birth Certificate, Passport Government-Issued ID, Other identifying document showing name and age.)

Other

Upload a maximum of 30 pages.

Learning Profile

Tell us about your child.

Tell us your child's strengths.

What challenges has your child experienced?

What does success look like at Pinnacle Academy?

Parent/Guardian Information

Parent Name (First & Last)

Address

Parent Phone

Parent Email

I authorize Pinnacle Academy to request official records from the previous school (if applicable). All information on this form is true to the best of my knowledge. Electronic Signature

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