Forest Academy Enrollment Form - FBR Public School Academies

Applying for (month and year): *

Student's Name (last, first, middle) *

Grade for fall: *

Student's Date of Birth *

Student's Birth Place (City) *

Gender *

Male

Female

Twin/Triplet? *

Yes

No

Student's Primary Residence (Street Address) *

City

State

Zip

Home Phone *

School District of Residence *

Previous School Attended

Ethnic Information (PER MI DEPT of ED). Check All That Apply. *

American Indian/Alaska Native

Black/African

Asian

Native Hawaiian/Pacific Islander

Hispanic/Latino

White

Parent/Guardian 1 Name *

Relationship to Student *

Legal Guardian? *

Yes

No

Address (if different from student)

City

State

Zip

Home Phone *

Cell Phone

Work Phone

Email Address *

Employer/Occupation

Parent/Guardian 2 Name

Relationship to Student

Legal Guardian?

Yes

No

Address (if different from student)

Untitled

State

Zip

Home Phone

Cell Phone

Work Phone

Email Address

Employer/Occupation

Please list all special needs and current medication of student

Has the student had Chicken Pox?

Yes

No

If yes, what date?

Does the student have an Individualized Education Plan (IEP)? *

Yes

No

If yes, what date?

Did the student receive Special Services from previous school? *

Yes

No

Check all services received

L.D.

E.C.D.D

E.I.

V.I.

H.I.

P.I.

A.I.

O.H.I.

T.B.I.

C.I.

E.S.L.

Resource Room

Self-Contained Classroom

Please list all languages spoken at home *

Are you sharing the housing of others due to loss of housing, hardship, or a similar reason?

Yes

No

Explain if it is a similar reason:Explain if it is a similar reason:

Are you currently residing at a motel, hotel, car or campsite because your home has been damaged or for economic reasons?

Yes

No

Are you currently residing in a shelter?

Yes

No

Are you currently living in a temporary housing arrangement due to economic hardship?

Yes

No

Does the student have a sibling(s) currently enrolled at Forest? *

Yes

No

Name(s)

Does the student have a sibling(s) also applying at Forest? *

Yes

No

Name(s) and Grade(s)

How did you find out about Forest Academy? If referred, please include the individual's name. *

Why do you want your child to attend Forest? *

Your Name and Date *