2021-22 Enrollment Application
Please complete the following questions if you would like to learn more about Hope Academy
* Required
Grade Entering in 2021
*
Choose
3rd
4th
5th
6th
7th
8th
Students Name
*
Your answer
Current School
*
Your answer
Birthday
*
MM
/
DD
/
YYYY
Gender
*
Choose
Female
Male
Ethnicity:
Choose
Hispanic/Latino
African-American
Caucasian
Asian
Native American
Multiracial
Other
With whom does the student applicant live?
Your answer
Student Home Address
*
Your answer
City
*
Your answer
State
*
Your answer
Zip
*
Your answer
Mother’s Name
Your answer
Home Address (If different from student)
Your answer
City
Your answer
State
Your answer
Zip
Your answer
Mother’s Home Phone
Your answer
Mother’s Cell Phone
Your answer
Mother’s E-mail Address
Your answer
Mother’s Employer
Your answer
Father’s Name
Your answer
Home Address (If different from student)
Your answer
City
Your answer
State
Your answer
Zip
Your answer
Father's Home Phone
Your answer
Father’s Cell Phone
Your answer
Father’s E-mail Address
Your answer
Father’s Employer
Your answer
Additional Family Member/ Guardian:
Your answer
Relationship To The Student
Your answer
Additional Family Member Home Address:
Your answer
City
Your answer
State
Your answer
Zip:
Your answer
Additional Family Member Cell Phone:
Your answer
Additional Family Member Email Address:
Your answer
What was your total household income last year?
*
Your answer
How many dependents live in the applicants home?
*
Your answer
If there are siblings in the home, what grade are they in? If none, write "none"
*
Your answer
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