Application for Admission: JOY Academy of Southern Nevada
JOY Academy of Southern Nevada admits students of any race, color, nationality and ethnic origin to all the rights, privileges, programs, and activities generally accorded or made available to students at the school. It does not discriminate on the basis of race, color, national and ethnic origin, in administration of its educational policies, admissions policies, and any other school-administered program.
Applicant's Full Name (Last, First Middle) *
Your answer
Preferred Name
Name student would prefer to go by
Your answer
Gender *
Required
Birthdate *
MM
/
DD
/
YYYY
Age *
Grade in School *
Previous Schools Attended
Your answer
Home Address *
Your answer
Mailing Address
Optional/If applicable
Your answer
Living With *
Father or Male Guardian's Name
Your answer
Father's Cell #
or home if no cell
Your answer
Father's Employer
Your answer
Father's Work Phone #
Your answer
Father's Email Address
Your answer
Mother or Female Guardian's Name
Your answer
Mother's Cell #
or home if no cell
Your answer
Mother's Employer
Your answer
Mother's Work Phone #
Your answer
Mother's Email Address
Your answer
List other children in the family
Your answer
Emergency Contact 1: Name & Relationship to student *
Your answer
Emergency Contact 2: Phone # *
Your answer
Emergency Contact 2: Name & Relationship to student *
Your answer
Emergency Contact 2: Phone # *
Your answer
Is there anyone who CANNOT pick up your child from school? Please list name and explain.
Your answer
Briefly include your child’s medical information. Please include any physical or emotional health information that would help teachers and administrators promote optimal student development, and medical attention when needed. *
Known Allergies, Medical Condition(s), Medication(s) or N/A
Your answer
What are your greatest desires for your child, and how do you see JOY Academy partnering with you to accomplish these goals? *
Your answer
Please describe your child’s interests and activities in the areas of academics, athletics, music, art, hobbies, talents or other special interests. What motivates your child? In which academic subjects does he/she excel, love, or show the most interest? *
Your answer
Information gathered here will be held in confidence by JOY Academy and only disclosed to those necessary to the admissions process. *
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This form was created inside of Dr. Connie Y. Stolworthy.