Enrollment / Registration

Child First Name

Child Last Name

Child Middle Name

Suffix

Sex:

Male

Female

Date of Birth

Día

Mes

Año

Age

Last School Attended

May we contact the school for transcripts?

Yes

No

Special Needs / Comments

Parent / Legal Guardian / Student Contact Information

Name

ACNOWLEDGEMENT OF AGREEMENT

As Parent/Guardian, I agree to pay the tuition and other school fees as required.

Home Address

Cell Phone

Home Phone

Work Phone

Email

Signature

Modo de dibujo seleccionado. Para dibujar, necesitas un mouse o un panel táctil. Usa la función de accesibilidad del teclado al seleccionar Escribir o Subir.

Emergency Contact

Contact Name

Relationship

Cell Phone

Home Phone

Work Phone

Are we authorized to contact them directly?

Yes

No

Comments

Signature of Party Providing Information

Modo de dibujo seleccionado. Para dibujar, necesitas un mouse o un panel táctil. Usa la función de accesibilidad del teclado al seleccionar Escribir o Subir.

Statement of Cooperation and Medical Treatment Form

Please Indicate Your Child's Health Status Below

health status

My child has no known health conditions.

My child has a known condition(s). Check all that apply.

Allergies (food or other)

allergies

Asthma

Year Diagnosed

Seizures/Epilepsy

Year Diagnosed

Sickle Cell Disease

Year Diagnosed

Diabetes

Select One

Type 1

Type 2

Other

Year Diagnosed

Other

Year Diagnosed

My Child Has a Primary Healthcare Provider

Has health provider

Yes

No

Provider's Name

Provider's Phone Number

I give permission for Drexel Academy designee to talk to the Provider about my child's health.

Parent/Legal Guardian Signature

Modo de dibujo seleccionado. Para dibujar, necesitas un mouse o un panel táctil. Usa la función de accesibilidad del teclado al seleccionar Escribir o Subir.

Enrollment Made Easy

We've made our enrollment process simple and family-friendly. Request an application, complete it at your connivence, and submit it when you're ready.

Enrollment / Registration

Parent / Legal Guardian / Student Contact Information

Emergency Contact

Statement of Cooperation and Medical Treatment Form