Summit Homeschool Academy

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Summit Homeschool Academy - Spring '23

Thank you for enrolling in Summit Homeschool Academy for the Spring Semester! To register your student, please:

1. Complete the registration form below.

2. If you have previously enrolled in a public school or public enrichment program, please submit a withdrawal form.

3. Finally, please remember to email a copy of your student's birth certificate and Immunization Records OR Exemption to: Director@Summitha.com.

Email *

Students Legal First Name (As stated on their birth certificate) *

Students Legal Middle Name

Student's Legal Last Name *

Student's Date of Birth (MM/DD/YYYY) *

YYYY

Student is registering as: *

Tuition Based ($277/month + $125 book fee) - your student will be self-funded, as state funding deadlines have passed.

Has the student ever been previously registered in a Colorado public school program? *

Yes

What school did your child most recently attend? *

If your child was previously registered in a public school, have you notified that district of their withdrawal?

Yes

Clear selection

Primary Contact Phone Number (Home phone) *

Parent/Guardian #1 - Name *

Parent/Guardian #1 - Phone Number *

Parent/Guardian #1 - Email Address

Parent/Guardian #2 - Name

Parent/Guardian #2 - Phone Number

Parent/Guardian #2 - Email Address

Street Address (Primary Address where student resides most of the time) *

City (Primary Address where student resides most of the time) *

Zip Code (Primary Address where student resides most of the time) *

What is your child's current grade level? *

Math Placement: Please Click on the highest grade level you believe your child has mastered (60% or better). Levels 7/8 cover Algebra 1 and Geometry. This program is rigorous and grade level does not typically correspond to math level. Once you've evaluated your child, select the level of math you have determined you would like them to be placed in for the upcoming year.
*

Level 1 - no prerequisites: child is learning numbers 0-100 and how to count them in order.

Level 2 - already knows all numbers 0-100 and writes them in order without help and can add and subtract single digits.

Level 3 - already knows numbers 0-1,000, can skip count, add and subtract double digits and understands fraction.

Level 4 - already knows how to multiply and divide by 2's-10's.

Level 5 - already knows how to round to the nearest 10,000, divide 3-digit numbers, complete word problems, multiply and divide up to 9, understands what fractions are.

Level 6 - PreAlgebra (typically 7th and 8th grade)

Level 7 - Algebra 1 (Typically 9th or 10th grade)

Level 8 - Geometry (Typically 10th-12th Grade)

Reading Placement: (Grades K-4 only) Please click on this link: https://www.allaboutlearningpress.com/placement/ . Scroll down to "Reading Placement" and follow the instructions. Once you've evaluated your child, select the grade level of reading you have determined they should be placed in for the upcoming year.
*

K - little to no previous reading, writing or spelling experience.

1 - knows all letters, sounds and is beginning to ready independently.

2 - Can read beginner books independently and write short stories.

3 - Can read intermediate books independently and write paragraphs.

4 - Is ready for grammar, poetry memorization and beginner literary analysis

Gifted and needs to be challenged at or above 5th grade reading

What grade level would you like to register your child for? *

If your student is registering for grade 1, 3, 5, 7 or 9, we include a Reading and Math MAPS BOY and EOY Assessment. The Assessment is completed at home by the parents on a specific day, scheduled by Summit. Would you like your child to be included in the assessment to measure growth? (More information can be found here: https://homeschoolboss.com *

Yes

Student has been identified with the following academic designations

504

IEP

Gifted

Other:

Clear selection

Please briefly describe any medical accommodations your child will need while on campus: This information is kept confidential and is only used for safety protocol implementation at Summit Homeschool Academy.

What is the primary language spoken in the home? *

Did the student first speak a language other than English? *

Yes

Emergency Contact #1 (Name & Phone Number - In the event a parent cannot be reached) *

Emergency Contact #2 (Name & Phone Number)

Emergency Contact #3 (Name & Phone Number)

Alternate Street Address (if the child lives at a second address part of the time)

Alternate City

Alternate Zip Code

How did you hear about Summit Homeschool Academy?
*

Please sign, stating this information is accurate, by typing your full name on the line below. *

Date Completed *

YYYY

A copy of your responses will be emailed to the address you provided.

Submit

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