Enrollment

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We value your child’s education, and we take pride in what we do. We believe there is no better school for your child to be apart of than Eagle’s Nest Academy. Take action and enroll today.

Enrollment Application

Student's Name

First

Middle

Last

Grade Enrolling at ENA

Age

Birth Date

Gender

Select an option from the dropdown menu

Address

Street Address, City, State, Zip, P.O. Box #

Email Address

Telephone Number

Area Code and Number

Cell Phone Number

Area Code and Number

School Last Attended

Name of School, City, and State

Did your child attend preschool?

Yes
No

Preschool Attended, Amount of years attended (If Applicable)

Did your child attend HeadStart?

Yes
No

Does your child have or need accomodations?

Yes
No

If so, please indicate what accomodations your child may have/need.

Does your child have a current I.E.P.? (Only pertains to special education students)

Yes
No

If yes, please fill out Consent Form for Release of Student Records, Files, Data and Behavior Records.

Has your child ever been suspended, expelled or have a behavior plan from another school district?

Yes
No

If yes, please fill out behavior release sheet, provide information and behavior plan/contract. Please fill out Behavior Records Release Form. **Board Policy No. 5111 authorizes the Director to deny admission to any student who has a record of bevaior that s/he believes would constitute a threat to the safety and well being of fellow students and staff.

How did you hear about the Academy?

(Social Media, Newspaper, Friend, etc.)

Name of Parent(s)

Employer Phone Number

Cell Phone

Emergency Contact

Name, and Phone Number

My student may not leave with:

Name and Reason

Present Living Situation

Select an option from the dropdown menu

With whom does this child reside?

Mother
Father
Stepfather
Stepmother
Guardian
Grandparent

Check all that apply

Siblings in Family

Name, Age, and Grade

Siblings Attending ENA

Name, Age, and Grade

Please Type Name as Your Electric Signature

By signing, you are agreeing that all of the above information is correct

Phone

Bus Route Request Form

Received Date

Office Use Only

Effective Date

Office Use Only

Bus Route (Please allow 3 working days for implementation)

Office Use Only

Name of Student

Last Name, First Name, Middle Initial

School

Grade

DOB

Name of Parent/Guardian

Address

Street Address, Apt #, City, State and Zip Code

Primary Phone

Is this a home number or daycare number?

Home
Daycare

Please check one option

Alternate Phone

Is this a home number or daycare number?

Home
Daycare

Please check one option

Alternate Address

Is this a home address or daycare address?

Home
Daycare

Emergeny Contact

Please list a different contact than in parent/guardian section

Phone

Please list a phone number associated with emergency contact

Address

Please list an address associated with emergency contact

Days of the week

Monday
Tuesday
Wednesday
Thursday
Friday

Check all that apply

Pick up my child at the nearest bus stop location to:

Drop off my child at the nearest bus stop location to:

Is this a home address or daycare address?

Home
Daycare

Please check one option

Is this a home address or daycare address?

Home
Daycare

Please check one option

I certify that I have read the student transportation handbook and I understand that if my child has an infraction of the rules that suspension from transportation may result.

Yes
No

Comments

Parent Electric Signature

Name

Open: Monday-Friday: 7:30 am to 4:30 pm
Address: 5005 Cloverlawn Dr. Flint, MI 48504-2084 | Tel: 810 869 6495 | Fax: 810 853 6404 | Email: info@eaglesnestflint.org

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Enrollment

Open: Monday-Friday: 7:30 am to 4:30 pmAddress: 5005 Cloverlawn Dr. Flint, MI 48504-2084 | Tel: 810 869 6495 | Fax: 810 853 6404 | Email: info@eaglesnestflint.org

Open: Monday-Friday: 7:30 am to 4:30 pm
Address: 5005 Cloverlawn Dr. Flint, MI 48504-2084 | Tel: 810 869 6495 | Fax: 810 853 6404 | Email: info@eaglesnestflint.org