Application

Student Information

Student's First Name

Student's Last Name

Year Applying For

Grade Applying For

Birth Date

Age

Gender

Male

Female

Home Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Guardian Information

Guardian 1 First Name

Last Name

Place of Employment

Occupation

Work Address

Address

City

State

Zip Code

Country

Work Phone

Cell Phone

Guardian 2 First Name

Last Name

Place of Employment

Occupation

Work Address

Address

City

State

Zip Code

Country

Work Phone

Cell Phone

Will both primary guardians listed above take and pass a formal background check?

Sibling Information

Please list the Names, Age, and School for all siblings

Student Academic Information

Please list any previous schools your child has attended. Be sure to include the names, locations, grades attended, and dates attended of the previous schools. If homeschooled, please provide when homeschooling begun.

Has your child skipped or repeated a grade? If so please explain.

Has your child ever been evaluated with a formal education or psychological battery of testing? If yes, please provide all copies of documentation with the application.

Does your child have an Individualized Educational Plan (IEP)? If yes please provide all copies of documentation with this application.

Do you suspect or have you identified that your child may have a learning difference? If yes, please explain.

Do you have any academic or personal goals established for your child that you would like us to be aware of?

What interests does your child have?

Student Health Information

Does your child have an allergies or physical limitations we should be aware of? If yes, please explain.

Please list any medications your child may need throughout the school year.

Is your child seeing any medical professionals on a regular basis? If yes please explain.

Is there anything about your child academically, physically, or emotionally that you would like to inform us of at this time?

Family Information

How did you hear about Deeply Rooted Academy?

Please explain why you have chosen Deeply Rooted Academy for you child.

How would you describe your understanding of the educational philosophy of Charlotte Mason? What are some aspects of this philosophy that resonate with you?

Do you have any unique expectations that you had for your child when choosing Deeply Rooted Academy as opposed to another school?

How can Deeply Rooted Academy best care for your child?

Please tell us about your child's temperament.

How often would you say your child partakes in outside activity?

What methods motivate your child to learn more?

If your family is involved in a local church, please provide us with the church name.

Name of person responsible for tuition and expenses

First Name

Last Name

After completing this application I will pay the $50 non-refundable application fee online.

Policy Information

Acceptance of any child at DRA is a decision of the DRA faculty. Acceptance is based on the compatibility of the school, the parents, and the child. Accurate and complete information relating to a child’s learning differences, emotional stability, or physical limitations should be disclosed during the application process. With such accurate information, our board and faculty can carefully and prayerfully evaluate how effectively we can meet the needs of each student.

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Non-Discrimination Policy

Deeply Rooted Academy, LLC admits students of any race, color, national and ethnic origin to all rights, privileges, programs, and activities generally accorded or made available to students at the school. DRA does not discriminate on the basis of race, color, national and ethnic origin in administration of its educational policies, admissions policies, and other school-administered programs.

Application

Student Information

Guardian Information

Sibling Information

Student Academic Information

Student Health Information

Family Information

Name of person responsible for tuition and expenses

Policy Information

Non-Discrimination Policy

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