Pine Mountain Academy & Preschool Application for Admission

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The online enrollment fee is $75.00 with a 4% convenience fee. Once you fill out the online form a link will come up to pay your enrollment fee. All enrollment forms must be accompanied by a $75 enrollment fee (one per student). The enrollment fee is non-refundable. The application will not be considered without the enrollment fee paid.

Email *

Students Full Name *

Current Address (Include city, state, and zip) *

Phone Number *

Date of birth *

YYYY

Place of birth *

Grade last attended *

Grade(s) repeated

Entering grade *

School(s) attended previous year

Ever dismissed, suspended, or disciplined at any school *

Yes

If yes, please explain

Please describe any specific health problems or disabilities

Has the student ever received special education services or had an IEP at any school *

Yes

If yes, please explain

Family Church, address, and pastor

In making this application I understand:

1. The school reserves the right to dismiss any student who does not respect its spiritual standards and cooperate in the educational process.

2. My cooperation with the school is expected in: (a) regular tuition payment, (b) practical help, and (c) faithful prayer.

3. The administration has full responsibility for placing my child in the proper grade.

4. The teacher has full discretion in the classroom discipline of my child.

5. My child may go on scheduled field trips and other school activities.

Enter name of parent or legal guardian and date
*

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