Admissions | Tampa, FL | Kidz Cove Academy

Name

FirstLast

Address

Street AddressAddress Line 2CityState / ProvinceZIP / Postal CodeCountry

Home Phone

Are You Over 18?

No
Yes

Primary Contact Phone

Email

Please give current school your child now attends

Name of School

Present Grade

Address

Street AddressAddress Line 2CityState / ProvinceZIP / Postal CodeCountry

Phone

Previous School Attended

Grades Attended

Previous School Attended

Grades Attended

Family Information

Mother's Name

FirstLast

Address

Street AddressAddress Line 2CityState / ProvinceZIP / Postal CodeCountry

Work Phone

Cell Phone

Email

Father's Name

FirstLast

Address

Street AddressAddress Line 2CityState / ProvinceZIP / Postal CodeCountry

Work Phone

Cell Phone

Email

Other Children: Please list their Name, Age, Grade, and School Currently Attending

Ethnic Origin

Applicant Information

Applicants Strengths

Areas in need of Refinement

Has the applicant ever been retained in a grade?

Required redial instruction or tutoring?

Placed on Probation or dismissed by school?

If so, please clarify?

Please note any special circumstances that would be helpful for us to understand in working with your child (adoption, family member illness, parenting arrangements):

Does the applicant have any health needs that need any special arrangements at school?

Does the applicant take any medication on a regular basis?

If so, please clarify

Has the applicant been evaluated and or treated for learning differences?

If so, please clarify

Upload Documents

Signature

Parent Signature (please write your name below)*

Date*

Security Check*

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Application for Admission

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Family Information

Applicant Information

Signature