Student Re-Enrollment Student Last NameDo you have an Arizona Empowerment Scholarship Account (ESA)?(Required) Yes No If yes, would you like us to bill re-enrollment to your statement? Yes No Choose your payment plan(Required)10 Month (August - May)One Payment (Due August 15th)Two Payments (Due August 15th & January 15th)Four Payments (Only available and required for those receiving ESA) August 15th, October 15th, January 15th, & April 15thWhat type of billing do you prefer?(Required)PaperEmailWhat email address do you want to recieve your bill?(Required) Student InformationStudent Name(Required) First Last Grade entering(Required)K1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade7th Grade8th Grade9th Grade10th Grade11th Grade12th GradeHas any of the information below changed?(Required) Yes No If the information below this field has changed, please select "Yes".Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Student Cell PhoneStudent Church AttendedCity where student attends church City Is the student a member of the church?YesNoIs the student covered under major medical insurance?YesNoName of Insurance CompanyParent / Guardian InformationParent / Guardian Name First Last Parent or Guardian PhoneMarital StatusMarriedWidowedDivorcedSeparatedIf parents are separated or divorced, who has legal custody of the child?Parent / Guardian Email(Required) We give the school permission to use a photograph that contains an image of our child in its publications, yearbook, social media outlets, or website. Yes No We give ACA permission to text us on rare occasions, primarily to inform you of a lockdown drill or to give you pertinent information in a timely way in case of an actual lockdown. Yes No STATEMENT OF AGREEMENT: Please sign the following statement after reading the Parent-Student Handbook.Arrowhead Christian Academy is a ministry of Northwest Valley Baptist Church and exists to provide a Biblically-based, academically excellent education. The primary responsibility of education, discipleship, and discipline of children belongs to the parents, and the school is an extension of the home working with the parents to reach these common goals. It is important to understand that the school setting is different from the home due to the number of people. Control is conducive to good teaching and thus guidelines have been established in the Parent-Student Handbook for the good of the whole. The best prevention for misunderstandings is to read and fully understand the Parent- Student Handbook. If you have questions, please contact the teacher or administrator. We realize that rarely is the entire constituency of an organization in total harmony with all of the rules and policies of that organization. What we ask is that you, as parents, agree to the following: I have completely read the Parent-Student Handbook and I agree to instruct my child to abide by the rules and to cooperate with school personnel while enrolled in Arrowhead Christian Academy. If I do disagree, I will not voice it to my child, other students, or parents but will go to the teacher or administrator about my concern. I also understand that the acceptance or dismissal of a student for any reason is at the discretion of the administration.Parent / Guardian Signature(Required) This field is hidden when viewing the formDate Δ
