AliYah Academy Registration Form

Thank you for choosing AliYah Academy! We're excited to help serve you in your homeschooling adventures.

School Year

Let's get started! First, what school year are you registering for?

Registration Year

Has your family registered with us before? Yes, we've signed up before No, this is our first time to sign up

Already signed up before?

You can easily re-enroll for the next school year directly on your family account page.

Family Information

Next, let's get some information about your family. We'll need your name, current street address, and the best way to reach you.

Father/Guardian's Name Father's First Name Father's Last Name

Mother/Guardian's Name Mother's First Name Mother's Last Name

Address Street Address

City State ZIP Code

County Country

Contact Information Phone Alternate Phone Email

Are you a member of Home School Legal Defence Association (HLSDA)? Yes No HSLDA Account Number

Are you a member of a co-op or support group? Yes No Co-Cop Name

Student Information

Way to go! Now let's get some information about each student you want to register.

Additional Information

We'd love to hear any information you feel would help us in serving and understanding your family's homeschooling needs. This information will only be for the purpose of getting to know your family better and will not be shared or included with your records.

Additional Information

Legal Bits

By submitting this form I declare that I am the parent or guardian of said child/children and that the information in this form is correct to the best of my knowledge. Submitting this form is the equivalent to my signature and is giving permission to AliYah Academy to request school documents for said child/children.

I Agree

Student

Student's Information

Student's First Name Student's Middle Name Student's Last Name

Birth Date Grade

Sex Male Female

Special Needs? Yes No Special Needs

Is this student transferring from another school? (Umbrella or traditional) Yes No

Required Records

Birth Certificate I'll mail/email a copy

Vaccine Records or Exemption Letter I'll mail/email a copy

Transferring School Information

To request the transfer of your student's records, we need to contact the previous school they attended.

School Address School Name School Street Address

City State ZIP Code

School County Country

School Contact Information School Phone School Fax