New Life Preparatory Academy
Application for Admissions
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Student Last Name *
Student Preferred Name (nickname)
Student Address *
City and State *
Zip Code *
Student Cell Number *
Student Primary Email Address *
Social Security Number *
The best time to contact you: *
Date of Birth *
Parent/Gardian or Spouse Contact Information
Parent/Gardian or Spouse First and Last Name *
Parent/Gardian or Spouse Relationship to You *
Parent/Gardian or Spouse Email Address *
Parent/Gardian or Spouse Cell Number *
Does Your Parent/Guardian or Spouse Text *
Work/Cell Phone Number
Emergency Contact #1 *
Emergency Contact #1 Address *
Emergency Contact #1 Phone *
Emergency Contact #2 Phone *
Highest Level of Education *
Please list any certifications, licenses, or diplomas you possess: *
Name of last school attended and Year *
Reason for leaving *
Reason for attending New Life *
Personal Information
So we can start to get to know you a little better, please answer the following questions.
Have you ever taken an online class before? *
If you have taken an online class before, please include the name of the school(s) and course(s) you have taken *
If this is your first online course, please type "I have not taken an online course before".
Do you have a computer at home?
If you do have a computer at home, does it have a Windows or Mac operating system?
What do you hope to accomplish at New Life Preparatory Academy? *
Is there anything else you would like to share with us about yourself?
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