Application for Admission
Please complete this entire form and provide SRA with your student's most current report card(s) and standardized test scores (if available). Pay $75 here on the website or drop off a check at the address above payable to SAVANNAH RIVER ACADEMY.
Email *
Enrollment Option *
Required
Student First Name *
Student Middle Name *
Student Last Name *
Name Used *
Age as of September 1, 2020 *
Gender *
Required
Birthdate *
MM
/
DD
/
YYYY
Place/County of Birth *
Current Grade *
Current School *
School Phone *
Has the applicant ever been (select any that apply): *
Required
If you checked any options in the previous question, please detail Student Name, Name of School, Year, Reason, and contact person
Does the applicant have any physical and/or psychological condition(s) that may limit regular school work or participation? (if yes please explain) *
Does the applicant have any other health problem(s) that Savannah River Academy should be made aware of? (if yes please explain) *
Does the applicant take any medication(s) on a regular basis, during school hours? (If yes, please list the medications, dosages, and times regularly administered. Only medications taken during school hours are needed.) *
Has the applicant ever been referred for or received professional, psychological, or education testing or personal counseling? (If yes, please provide the school with a copy of test results or consultation report.) *
Required
Has the applicant ever taken, or is currently taking, any medication(s) for ADD / ADHD? (The existence of ADD/ADHD and/or the taking of medications shall not be the basis for denial of admission to Savannah River Academy.) *
Required
Are you interested in our dyslexia program? *
Required
Parent 1 data: Full Name, Home address, Home Phone, Cell Phone, Place of Employment, Nature of Work / Position, Work Phone, Preferred Email *
Parent 2 data: Full Name, Home address, Home Phone, Cell Phone, Place of Employment, Nature of Work / Position, Work Phone, Preferred Email *
Parents' marital status *
Living arrangements of applicant *
If parents are divorced, who has legal custody? *
Who will be financially responsible? *
Please list the names and grades of other children in the family and include name of school(s) currently attending *
By typing my name and the date below, I certify that the information contained in this application is true and accurate to the best of my knowledge. I also grant permission for Savannah River Academy to request my child's records. *
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