Application This form will allow parents to initiate the application process Step 1 of 4 25% Student Full Name*Date*Current Address*Parent/Guardian #1 Name & Phone Number*Parent/Guardian #1 E-Mail Address*Custodial Yes No Parent/Guardian #2 Name & Phone NumberParent/Guardian #2 E-Mail AddressCustodial Yes No Parents Completed High School* Both One Neither Parents Attended College* Both One Neither Marital Status* Married Divorced Separated Never Married Student's Cell Phone NumberStudent's E-Mail Address*Date of Birth*Current Grade Level*Social Security or Student ID*Sex* Male Female Type of Enrollment being Requested :* Full Time Student (College Prep Program) Home School Collective - Full Nurture and Up to 4 additional classes Home School Support - Limited Nurture - Secondary Enrollment for On-Line Students Type of Admission Traditional Admission: Student is matriculating from a school ( Public or non-connected Private School ) where 8th grade has been completed and the natural next step is a new institution. Home School Admission: Student is transitioning from a traditional home school setting. African Centered Matriculation: Student is matriculating from an identified African Centered program. [Children of The Most High, Imhotep Academy, Kilombo Pan-African Institute] Transfer Student Name of Last School AttendedSchool AddressSchool Phone NumberStart Date*End Date*Current Enrollment Status 8th Grade Graduate/Candidate Withdrawn Dual Enrollment Candidate Home Schooled Is your family free of any financial obligations to a previous institution?* Yes No Has student been cleared of any conduct or discipline issues at previous institutions?* Yes No Is student currently in good standing with all previous institutions?* Yes No If "no" to any of the 3 previous questions, please explain :List all other institutions attended in the last 5 years with contact information. What is the last grade completed (or current Grade level equivalent)?*Student's Current G.P.A.Academic Designation(s):* Select All IEP IDEA 504 Plan Talented /Gifted (Student will be tested) Behavioral STP None Select all that applyI (Parent) give T.S.K. Prep the right to contact all previous educational institutions listed on this application for the purposes of creating an academic profile for my child.* I Agree I Disagree I am aware that T.S.K. Prep is a drug free enviornment. I give permission for my child to be tested prior to admission, and on a random basis as seen fit by the administrative staff. I am aware that any illegal substances found in his or her blood stream does not mean immediate denial of admission or expulsion but will be addressed as a major concern of this academic community. *USERS MUST BE IN A TREATMENT PROGRAM * I Agree I Disagree Who will serve as Student's Primary learning support coach at home?:*Coach's highest educational degree/certification ( High School Diploma Required):Learning Coach is a custodial parent?* Yes No If Potential Learning Coach is someone other than a custodial Parent, what is the relationship to the student?Thank you for your interest in Tamu Sana Kanyama Preparatory Academy High School Program or Nurture Program for S.W.AT.L. Home School Connection. We look forward to meeting with you and your family. Someone from our staff will be contacting the parent listed as #1 to schedule an interview and admission test. I understand that this is not an offer of admission and that by completing this application I am requesting admission to this institution with knowledge of tuition costs and attendance requirements. TSK Transcript Request T.S.K. Parent Compliance Check List Vaccine Exemption Blank_Immunization_Form_3231 Intake Transcrip Request
