Enrollment Application

H.O.K.E. ACADEMY
Helping Our Kids Exceed

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STUDENT INFORMATION

Student Last Name*

Student First Name*

Student Middle Name*

Birthday*

Month

Day

Year

Student Age*

Grade Enrolling*

Most Recent School*

School Address*

School Email

School Phone*

My child has special needs (IEP, 504 Plan, etc.)*

Yes

If yes, please indicate which needs must are identified.

IEP

Speech

Behavior Plan

ADD/ADHD

Autism Spectrum

Academically Delayed

Other

My child has been evaluated and placed in gifted/advanced classes*

Yes

If yes, which subject(s)?

English Language Arts

Math

I understand that my child will require testing to support this finding or that I may be required to submit evidence of her/his placement.

My child is on medication*

Yes

If yes, please indicate which medications she/he is on.

Please indicate whether your child has any allergies or medical conditions that we need to be aware of.

My child HAS NOT been expelled from any previous school(s)/daycare.

I HAVE NOT been told during any parent-teacher conference that my child may have trouble with focusing, bullying, following directions, or being disruptive.

PARENT/GUARDIAN 1 INFORMATION

Parent First & Last Name*

Address*

Phone*

Email*

Social Security Number*

DOB*

Occupation/Student Status*

Employers/School*

Employer/School Address*

PARENT/GUARDIAN 2 INFORMATION

Parent First & Last Name

Address

Phone

Social Security Number

DOB

Occupation/Student Status

Employer/School

Employer/School Address

Application Process

Phase I

Complete the enclosed Admissions Application for each child

Submit registration fee of $150 (non-refundable)

Attend Interview I

Phase II

Student assessment/exam (upon satisfaction of the Phase I interview)

Attend Interview II

If accepted, submit all required documents and sign Enrollment Agreement forms

Proof of age (official copy of birth certificate)
Immunization records/Health Assessment (for new NC students and Kindergarten)
Most recent report card or transcript
Standardized test results
Special needs assessments/assignment
Gifted/Honor/AP assessment/placement
Enrollment Agreement

Submit $300 Laptop/Curriculum Fee (non-refundable)

Additional Information Regarding Kindergarten Registration

Must be turning 5 years of age on or before September 31^st of the enrolling year
Special Admission Request - *Students whose 5^th birthday falls between October 1^st and December 31^st may be admitted on a special request. Acceptance will be based on academic assessment, maturity, and emotional evaluation.
must have Kindergarten Health Assessment form and updated immunization record

H.O.K.E. Academy admits students of any race, color, national or ethnic origin to all the rights, privileges, programs and activities generally accorded or made available to students of the school. H.O.K.E. Academy does not discriminate on the basis of race, color, national or ethnic origin, the administration of its educational policies, enrollment policies, scholarships, athletic programs and other school-administered programs. As a private institution in the State of North Carolina, H.O.K.E. Academy reserves the right to set and maintain our own standards of student conduct, dress, tuition, fees for services and scholarships. H.O.K.E. Academy reserves the right to refuse admission or to dismiss anyone who violates the school’s standards set forth in any handbook or as defined by the school board and/or administration. H.O.K.E. Academy also reserves the right to change any policy as deemed necessary to preserve the integrity of the school with or without notice.

Students are considered officially enrolled upon acceptance by the Head of School, Assistant Head of School (for the grade level), and

Upon receipt of all documents and all fees have been processed
Upon payment of the 1^st months tuition

I have read and understand the application process

I understand that once I enroll my child at H.O.K.E. Academy, I am committed to the school year’s tuition in its entirety, regardless of military orders, relocation, or any other unforeseen circumstance.

I understand that after enrolling my child, if at any time H.O.K.E. Academy administration discovers that any of my responses were answered dishonestly, H.O.K.E. Academy reserves the right to terminate enrollment and I will still be held responsible for the contracted tuition balance.

I acknowledge that because classrooms are small, and to ensure the school is able to meet the needs of all of students academically, behaviorally, and socially, only allow one child with a diagnosed IEP, 504 Plan, or special need will be enrolled per class.

I understand that I am submitting this application along with the non-refundable $150 Application Fee.

Please upload the required documents for enrollment:

Birth Cetificate

Immunization Records

Most recent report card or transcript

Parent 1 ID (must be a government issued ID)

Parent 1 SS Card

Parent Signature*

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Submit Application Fee*

Application Fee$150

H.O.K.E. ACADEMY Helping Our Kids Exceed

ENROLLMENT APPLICATION

H.O.K.E. ACADEMY
Helping Our Kids Exceed