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Welcome
Academics
Admissions
Gallery
Extracurricular
Portal Login
Contact
Enrollment Form
Please complete the form below
Re-Enrollment
New Enrollment
Name
*
First Name
Last Name
Grade
*
Email
*
Home Phone
*
(###)
###
####
Sex
*
Birth Date
*
Race
US Citizen (Yes/No)
*
Father's Name
*
Mother's Name
*
Father's Employer
*
Work Phone
*
(###)
###
####
Mother's Employer
*
Work Phone
*
(###)
###
####
Child's Living Arrangements:
*
Both Parents
Mother
Father
Other
Name of person authorized to pick up child/Emergency Contact
*
Relationship to you/child
*
Phone
*
(###)
###
####
Name of person authorized to pick up child (other than parent)
*
Relationship to you/child
*
Physician Phone
*
(###)
###
####
Physician's Name
*
Health Problems/Allergies (if any)
School Attended Last Year
*
City/State
*
Phone
*
(###)
###
####
Reason for selecting AIM:
*
Has your child ever been suspended or expelled from school?
*
Yes
No
Has your child ever failed a grade or been held back?
Yes
No
Has your child ever received any special education services or classroom accommodations?
Yes
No
Has the student ever undergone counseling for discipline, psychological or other reasons?
Yes
No
Brief Description
Church you now attend
*
Pastor's Name
*
Phone
*
(###)
###
####
Parent Signature
*
Date
*
Thank you!
