Summit Homeschool Academy 22/23
Thank you for enrolling in Summit Homeschool Academy.  To fully enroll your student, we request that you complete the following form which will collect all of the information necessary for us to receive funding for your student.  Please complete this by Friday, September 30th. 
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Email *
Students Legal First Name (As stated on their birth certificate) *
Students Legal Middle Name
Student's Legal Last Name *
Student is registering as: *
Has the student ever been previously registered in a Colorado public school program? *
If your child was previously registered in a public school, have you notified that district of their withdrawal?
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What school did your child most recently attend? *
Student's Gender *
Student's Date of Birth (MM/DD/YYYY) *
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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.
Student has been identified with the following academic designations
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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) *
Ethnicity:  Is the student of Hispanic/Latino Origin? *
Race:  Please check the box below that best represents your child's race: (check one) *
Required
What is your child's current grade level? *
Math Placement:                                                       Please click on this link: https://www.singaporemath.com/pages/placement-tests .                                                                                    Scroll down to "Placement Tests" and click on the "Dimensions Math" arrow. 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 grade level of math you have determined you would like them to be placed in for the upcoming year.
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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.  
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What grade level would you like to register your child for? *
If your student is registered 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 *
In what county does the student currently reside? *
What public school district does the student currently reside?  (Enter UNKNOWN if not sure)
What is the primary language spoken in the home? *
Did the student first speak a language other than English? *
Does the child currently have a parent who serves in the US Military? *
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?
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Please sign stating this information accurate by typing your full name on the line below. *
Date Completed *
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