Apply for Enrollment | Grove Heritage Academy

Legal First Name *Required.

Legal Middle Name

Legal Last Name *Required.

Preferred Name / Nickname

Date of Birth *Required.

Gender

Grade Applying For *Required.

Anticipated Start Date

Enrollment Type *

Full-Time: 5 or more courses per year Part-Time: 1 to 4 courses per year

Diploma Track Preference

Standard Diploma: 25.5 credits College Preparatory Diploma: 28 credits Undecided: I'd like guidance from an advisor

Primary Parent / Guardian

First Name *Required.

Last Name *Required.

Relationship to Student *Required.

Email Address *Valid email required.

Cell Phone *Required.

Home Phone

Mailing Address, Street *Required.

City *Required.

State * Required.

ZIP Code *Required.

Preferred Contact Method

Email Phone Text No Preference

Secondary Parent / Guardian

First Name

Last Name

Relationship to Student

Email Address

Cell Phone

Home Phone

Mailing Address, Street

City

State

ZIP Code

Preferred Contact Method

Email Phone Text No Preference

Marital Status of Parents

Church Name and Denomination

Pastor's Name

How long has your family attended this church?

Number of children in household

Number of children enrolling at Grove Heritage Academy

How did you hear about us?

If referred, by whom?

Previous School / Program Name *Required.

City, State of Previous School

Dates Attended

Type of Previous Education

Last Grade Completed

Current GPA (if known)

Has the student ever been expelled, suspended, or asked to leave a school? *

No Yes

Please explain

Has the student ever been held back or repeated a grade? *

No Yes

Please explain

Has the student ever received special education services, an IEP, or 504 plan? *

No Yes

Please describe

Does the student have any diagnosed learning differences or disabilities? *

No Yes

Please describe

Official transcripts or academic records from the student's previous school will be required before enrollment is finalized. These can be mailed or emailed to our admissions office.

Final course placement will be determined in consultation with an academic advisor. Please indicate your preferences below.

Bible & Theology (select one)

Old Testament Survey New Testament Survey Christian Worldview Apologetics

English (select one)

English 9 English 10 English 11: American Literature English 12: British Literature

Mathematics (select one)

Algebra I Geometry Algebra II Pre-Calculus Consumer Mathematics

Science (select one)

Biology Chemistry Physics Environmental Science

Social Studies (select one)

World History U.S. History U.S. Government & Economics Geography

Foreign Language (select one)

Spanish I Spanish II Not taking foreign language this year

Briefly describe your family's faith background and church involvement *Required.

Why are you choosing a Christian education for your student? *Required.

What are your hopes and goals for your student at Grove Heritage Academy?

Does the student profess a personal faith in Jesus Christ?

Yes No Exploring

Is there anything else about your student's character, interests, or circumstances that would help us serve them better?

Primary Care Physician Name

Physician Phone Number

Health Insurance Provider

Policy Number

Known Allergies *Required. Write "None" if none.

Current Medications *Required. Write "None" if none.

Medical Conditions or Concerns *Required. Write "None" if none.

Does the student require any accommodations for medical reasons?

No Yes

Please describe the accommodations needed

Emergency Contact (other than parents listed above)

Name *Required.

Relationship to Student *Required.

Phone Number *Required.

Please read each statement carefully and check the box to confirm your agreement. All items are required.

I certify that all information provided in this application is true and accurate to the best of my knowledge. I understand that providing false information may result in denial or revocation of enrollment.

I have read and agree to the Grove Heritage Academy Statement of Faith. I understand that all instruction is delivered from a biblical Christian worldview.

I understand that Grove Heritage Academy is a homeschool program and that as the parent/guardian, I am the primary educator responsible for my student's daily learning.

I agree to maintain open communication with Grove Heritage Academy staff regarding my student's academic progress, behavior, and well-being.

I understand that official transcripts or records from my student's previous school must be submitted before enrollment is finalized.

I understand that tuition and fees are due according to the payment schedule and that failure to maintain payments may result in suspension of services.

I consent to Grove Heritage Academy maintaining academic records, transcripts, and personal information for my student in accordance with applicable privacy regulations.

By typing your full legal name below, you are providing a digital signature and acknowledging that you have read and agree to all statements above.

Full Legal Name *Digital signature required.

Date

Relationship to Student *Required.

Enrollment Application

Application Received

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