Application Form
Complete this inquiry to help us understand your child and follow up with personalized next steps.
Application Form
Child Information
First Name
Middle Name
Last Name
Birthday
Grade Next Year
- Select -
Pre-K4
Kinder
1st
2nd
3rd
Are you interested in enrolling more than one child?
Yes
No
How many additional children do you need to enroll?
Primary language spoken at home
Children #2
First Name
Middle Name
Last Name
Birthday
Grade Next Year
- Select -
Pre-K4
Kinder
1st
2nd
3rd
Children #3
First Name
Middle Name
Last Name
Birthday
Grade Next Year
- Select -
Pre-K4
Kinder
1st
2nd
3rd
Children #4
First Name
Middle Name
Last Name
Birthday
Grade Next Year
- Select -
Pre-K4
Kinder
1st
2nd
3rd
Children #5
First Name
Middle Name
Last Name
Birthday
Grade Next Year
- Select -
Pre-K4
Kinder
1st
2nd
3rd
Family Contact Information
Family Address
Address Line 1
Address Line 2
City
State
Postal / Zip Code
Family Phone Number
Father's Name
First Name
Last Name
Email
Email
Mother's Name
First Name
Last Name
Email
Email
Emergency Contact
First Name
Last Name
Relationship
Home Phone Number
Mobile Phone Number
Student History
Please list the names(s) of the school(s) your child has previously attended.
Do any of your children require learning accommodations or additional support?
Yes
No
Please share any information that would help us best support your child
Have any of your children ever been suspended, asked to withdraw, or expelled?
Yes
No
Please provide additional context regarding the situation.
Have any of your children ever been recommended for academic or psychological testing?
Yes
No
Please provide any relevant context you feel comfortable sharing.
Do any of your children have any history of trouble with authorities?
Yes
No
Please provide any relevant context you feel comfortable sharing.
Acknowledgements
Trellis Academy admits students of any race, color, nationality, and ethnic origin to all rights, privileges, programs, and activities generally afforded or made available to students at the school. It does not discriminate on the basis of race, color, nationality and/or ethnic origin in the administration of its educational policies, admissions policies, and other school-administered programs. I have read the school’s statement of faith. I understand that instruction is delivered through the lens of a Biblical worldview. I affirm that all the information in this application is true and correct to the best of my knowledge. I understand that providing false information or omission of pertinent information could be reason for the rejection of the application or dismissal of my child from Trellis Academy. I also understand that I may be asked to provide additional information.
I have read and agree to the
Terms and Agreement
Please type your full legal name. By doing so, you agree that this text entry constitutes your electronic signature and carries the same legal weight as a handwritten signature.
Parents / Guardian Signature
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