Covenant Path Academy Student Application - Walk Beside Me Learning / Covenant Path Academy

We’re here to help you enroll your child in Covenant Path Academy. Please complete ALL fields in the application form below. After the application has been submitted, please follow the link to pay the application fee. All other items must be received within 10 days from the date of the application.

Your complete application should include:
1. completed application form with recent photograph
2. all previous years’ academic records. Transcripts for high school students.
4. Non-refundable application fee ($75, all grades 1-12)

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Student Name

First

Middle

Last

Student's date of Birth (MM/DD/YYYY)

Student Gender

Intended Year of Enrollment

Grade Level for Upcoming Year

Child's Home Address (Please provide complete address)

Please include house number, street name, city, state, and 5 digit zip code. This application must contain a current mailing address for your child. We will ship books, curriculum, documents, and other items directly to your home.

Mother's Full Name

Mother's Phone Number (000-000-0000)

Please provide your most accessible contact number.

Mother's Full Address

If same as child's address, write SAME.

Mother's Email

Mother's Occupation and Employer

Father's Full Name

Father's Phone Number (000-000-0000)

Please provide your most accessible contact number.

Father's Full Address

If same as child's address, write SAME.

Father's Email

Father's Occupation and Employer

Student's Parents Are...

Please explain any special family circumstances that may affect your child’s learning:

PARENT PERMISSION CONFIRMATION

By selecting "YES", I acknowledge that either parent or guardian above may obtain information for my student from Covenant Path Academy at any time. Any exceptions must be specifically described in writing, and sent by mail to Covenant Path Academy; PO Box 158; Manti, UT 84642.

STUDENT HEALTH

Does student have any health condition, physical or emotional, that may require special accommodations in his/her education? If yes, explain.

LEARNING ACCOMMODATION

Does student have, or has he/she ever had an IEP, a 504, or any other type of customized learning plan or accommodation? If yes, please explain.

FINANCIAL RESPONSIBILITY

First

Last

Person responsible for tuition and fees and relationship to the student, if any.

Billing Address

Address, City, State or Province, Zip or Postal Code, Country

ACADEMIC HISTORY

List all schools student has attended, beginning with the most recent. We will use this address to request your student's records. Please include school name, complete address, school phone number, and name of school counselor, if available.

PERMISSIONS & ACCEPTANCE

The information herein given is for the purpose of obtaining admission to Covenant Path Academy. I certify that it is correct to the best of my knowledge. I give Covenant Path Academy administrative personnel my permission to contact former schools and/or references for the purpose of determining admission to the Academy.

APPLICATION FEE

I understand that an application fee of $75.00 must accompany this application. If I withdraw my application, I understand the fee is not refundable.

INTERNET CONNECTION

The Academy’s online program necessitates a reliable internet connection to deliver content and submit assignments. Please acknowledge that you have a good internet connection available on a daily basis.

PARENT SIGNATURE

By typing my name, I am confirming that the information I have provided is true and complete to the best of my ability. If any information changes, I will contact the school. I also agree that by submitting this application, I agree to pay any and all fees accrued and/or associated with my child's program.

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+1 435 314-5008

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