N e w H o p e A c a d e m y
o f T e n n e s s e e

Private Christian School & Resource Center
"We help you homeschool"
Book-based and Online Programs

About

Enrollment Form

By clicking here, I acknowledge that I am the parent or guardian of this student, and I have read, understand, agree with, and will comply with the linked document(s).

Student's Full Name

Birthday

Choose an option

Student's Grade (Current year)

Is this student returning from the previous school year?

Street Address

City

State

Zip Code

School District of Residence

Check all that apply to this student now and/or during the past two years. * Required

Had truancy issue (Including letter(s), calls, truancy board, hearing, or court)

Suspended (ISS / OSS), expelled, or alternative school

Been arrested, held, investigated, or on probation

Drug or alcohol usage, addiction or rehab

Is pregnant, an expectant father, or the parent of a child

Has a GPA of less than 2.0

If you checked any of the boxes above, provide specific details below.

Check the box relating beside any question(s) that apply to your family or anyone that resides in your household now and/or during the past two years. * Required

Investigation by the Department of Human Services

Investigation by Child Protective Services

Under police investigation or conviction

On the sex offender registry

If you checked any of the boxes above, provide specific details below.

#1. Primary Contact: Father, Mother or Guardian's Full Name (First point of contact)

#1. Phone Number

#1. Email Address

#1. Place of Employment

#2. Father, Mother or Guardian's Full Name (Type NA if not applicable)

#2. Phone Number

#2. Email Address

#2. Place of Employment

Name of the primary teacher for this student

Phone Number of Primary Teacher if not the parent listed above

Email of PT if different from parent listed above.

Primary Teacher's Relation to Student

If "Other", please explain

Have you previously submitted a diploma, GED, transcript, ect. of the parent or primary teacher of this student?

By clicking this box, as the parent or guardian of this student, I give NHAT staff permission to communicate with the primary teacher concerning this student: enrollment, classes, progress, instruction, records, reports, and for all other educational concerns of this student.

By signing below I hereby acknowledge that the information provided on this enrollment form is true and accurate to the best of my knowledge. Acceptance of enrollment is conditional upon approval and receipt of all student records. While truancy, arrest, probation, suspension, expulsion, low GPA, investigations, and other issues may not disqualify for enrollment, falsified information will nullify the enrollment without refund and with forfieture of fees paid. Accordingly, questions must be answerd as truthfully as possible. I understand that enrollment is conditional upon approval. For transfer students, I hereby grant NHAT permission to request this student's records from the previous school(s) for evaluation and/or enrollment.

Parent/Guardian's Signature (Digital)

Date

New Hope Academy

of Tennessee

NewHopeAcademyTN@gmail.com

4924-C Fort Henry Dr.

Kingsport, TN 37663

(Regency Square Bldg.)

Phone: (423) 239-9700

Fax: (423) 239-9300

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