Interest Form

Saint Pierre Academy Enrollment for Home and Hybrid School Scholars

APPLICATIONS ARE NOW AVAILABLE!

Enrollment is as easy as 1-2-3!

Step 1.  Fill out the interest form below. You will receive an invitation to a phone interview based on your selection.

Step 2. Attend the phone interview. Share important information that helps us to determine if we can make a cohort and mentor match.

Step 3. Upon acceptance into your chosen cohort, confirm your payment preference and complete the required forms.  You will receive orientation information to adequately prepare for the year.

Submit Your Interest Form Now!  Cohort group sizes are limited.  All parents of scholars between the ages of 8-15 must complete an enrollment form prior to receiving an interview time.  Once an application is received, it is reviewed to match your scholar with a cohort and mentor, based on age, grade and interests.  For the best experience on Tuesday and Thursday in-person sessions, our target cohort size is 8, with the maximum being 15 scholars.  Friday is an opportunity for scholars from different cohorts to meet!

Scholar Name *

First

Last

Grade for the 2023-2024 Academic Year *

Date of Birth *

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Parent/Guardian Contact

Name *

First

Last

Email *

Relationship to applicant *

Address *

Address Line 1

Address Line 2

City

AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Phone *

This application is for enrollment for the follow program: *

• Homeschool/Hybrid School Enrichment
• Student Success Mentorship
• Special Interest Groups (Clubs, Contests, Civics)
• Project Based Learning Groups (Academic and Career Skills)
• Personalized Education Plan
• All of the Above

The Homeschool and Hybrid school option includes Student Success, Special Interest Groups, and Project-Based Learning. If your scholar is attending another school, select the enrichment program of greatest interest. We can always add an additional program after official enrollment.

What is your favorite subject? *

If you are seeking homeschool/hybrid school support, when did you first start? *- Please Select -I am new to homeschool/hybrid schoolI have homeschooled for 1-2 yearsI have homeschooled for over 3 yearsNot applicable. My child will remain in their current school, but we are seeking additional support.

This will help us understand which resources to send you prior to the program start date.

Has your scholar ever been subject to disciplinary action for scholastic or any other type of misconduct at any educational institution? *

• Yes
• No

This does not immediately disqualify your scholar. However, this helps us know how to match with mentorship to bring out the best in your child while keeping our programs safe and effective for the community.

If yes, please explain

Has your child needed special accommodations for a social, physical, or learning difference? *

• Yes
• No

Due to the nature of our programs, we want to make sure that we make reasonable recommendations and program placements.

If yes, please explain

School Information

School Name (or Homeschool) *

Expected Graduation Date *

School Address

Address Line 1

Address Line 2

City

AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

School Phone

Emergency Contacts

Name *

First

Last

Relationship *

Phone *

Name

First

Last

Relationship

Phone

Extracurricular, Personal and Volunteer Activities

Extracurricular Activities

List your organizations, position, description of the activity, and hours per week of involvement.

Talents and Awards

List each, a description, the level, and number of years of involvement.

Community Service Work

List the type of work, your role, and hours per week of involvement.

Employment

List the job, your title, description, hours per week, and dates of employment.

Additional Information

The information requested below is optional, but it may assist in the review of your admission. You are strongly encouraged to complete this section.

Do you or your scholar have family obligations that keep them from regular participation in programs and activities?

• No
• Yes, we have a family business, travel frequently, and/or have frequent schedule changes.
• Yes, we provide primary care for a family member.
• Other

If yes or other, please describe

Agreement

I understand that this application is for admission only. I agree to the release of any academic records to this institution upon request, including any SAT, Achievement Test, and ACT score reports, if available. *If homeschooled, I agree to abide by the educational policies of my Local Education Agency (e.g., Local School Board) and the policies of Saint Pierre Academy.

Do you understand and agree to the terms listed above? *

• Yes, I understand and agree to the terms listed above.

Submit