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ADDRESS

PHONE

8624 A D Mims Road

Orlando, FL 32818

(407) 292 - 8481

© 2023 by West Oaks Academy

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STUDENT

APPLICATION

Download the Student Application Package sign and upload at the end of application

Student Full Name

Grade Entering

Date of Birth

Sex

Male

Female

Race

Place of Birth

Age

Social Security Number

Address

City

State

Zip Code

FAMILY

Mother's Name

Drivers License

Address

City

State

Zip Code

Email

Phone Number

Occupation

Company

Position

Father's Name

Drivers License

Address

City

State

Zip Code

Email

Phone Number

Occupation

Company

Position

Marital Relationship (check all that apply)

Natural Parents Are:

Together at home

Seperated

Legally Divorced

Natural Mother Deceased

Natural Father Deceased

If parents are divorced or seperated: Who has custody of the child?

Is either parent forbidden by court order from having equal access to the child or the school records?

Name of legal guardian if other than parent: (written documentation is required prior to enrollment)

If student does not live with natural father and mother, student lives with:

Natural Mother Only

Natural Father Only

Natural Mother & Stepfather

Natural Father & Stepmother

Guardian

If there are other children in your family, please complete the following:

Name

Age/Grade

School

Name

Age/Grade

School

Name

Age/Grade

School

Emergency Contact

Name

Relationship

Phone

Name

Relationship

Phone

Name

Relationship

Phone

School History

Please check here, if this is your child's first school experience

List all school previously attended (including West Oaks Academy if previously enrolled)

Has your child ever been

Suspended

Expelled

Asked to withdraw

None

Has your child, to your knowledge; been involved with alcohol, drugs, or tobacco?

Has your child, ever repeated a grade?

If so, state grade and date

Why is your child withdrawing from his/her present school?

Why have you selected WEST OAKS ACADEMY for your child's education?

Health

Complete health records on Florida form 680 must be received as a part of the application. A recent physical exam is also required for all kindergarten students and all new students to the state of Florida. If you are a Florida resident, an original form from your doctor or photocopy from your school record is acceptable. If you are applying from another state, please download the instruction sheet regarding Health Records

If you have futher information, which may assist in the education of your child at WEST OAKS ACADEMY, ( such as pertinent medical records or other data of which the school should be aware) Please indicate below

Child Allergies

Is there any medical reason the applicant cannot participate in the physical education program?

Yes

No

If "yes", please explain

Who is the applicant's physician?

Physician's Phone Number

Has your child had Chicken Pox?

Yes

No

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