Horizon Academy Application Form
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Email *
Registration for admission/ desired start date? *
Last completed class: *
Child's full name (first/ middle/last): *
Age: *
Date of birth (month/day/year): *
Gender: *
Home address: *
Place of birth: *
Language spoken at home:
Religious affiliation:
Father's name:
Father's phone number:
Father's email address:
Father's place of employment and work address
Father's occupation/ job title
Mother's name:
Mother's phone number:
Mother's email address:
Mother's place of employment and work address
Mother's occupation/ job title
Applicant lives with/ Legal Guardian(s)
Please check if any of the below applies:
Please list the child's siblings and their respective ages.
Present school:
Date started:
Reason for transfer:
Is the child currently placed in his/her age-appropriate class? *
If the answer to the above question was no, please explain.
Does your child have any special education needs? *
If the answer to the above question was yes or unsure, please explain.
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