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Application for Enrollment
We are delighted to welcome your child to COVA. Please complete the form as fully as possible and check your work carefully. Within a day or two of submitting the form you will be contacted by the director.

The application period for the 2009-2010 school year is November 1st - December 15th, 2008. Applications received after December 15th, 2008 will be processed on a space available basis.

Enrollment Period
*  indicates a required field
Applications are currently being accepted for the 2009 - 2010 school year and the 2010 - 2011 school year.
* I wish to enroll my child for the period beginning
* Grade my child will be in or entering at that time
* Child's Date of Birth
Student Information
  * First MI * Last
* Name
Nickname * Gender    
Email address
* Street Address     Unit No.
* City     * ST * ZIP
  * Home Mobile
Telephone
Last School Attended
School transcripts will be required prior to the start of school.
* School name
Telephone no.
Complete address
Parent / Guardian Information
Please use this block for the person completing this form.
Parent / Guardian 1 * Relationship to Student
* First name MI * Last name
Email address
* Street Address Unit No.
* City   * ST * Zip
  Daytime Evening Mobile
* Telephone
Parent / Guardian 2 Relationship to Student
First name MI Last name
Email address
Street Address Unit No.
City   ST Zip
  Daytime Evening Mobile
Telephone
Legal Custody Information
Student lives with
(Check all that apply)
* Are there any legal orders restricting who may contact the student at school, be contacted by the school, or receive information about the student?

If yes, please explain below. Legal documentation will be requested.

Emergency Contacts
In case of emergency, if the parent/guardian listed cannot be reached, please provide two other contact names and phone numbers.
  Full Name Phone Daytime Phone Mobile
* 1
* 2
Medical Information
* Does your child experience any medical problems that
the school staff should be aware of?
Medical conditions. Please check all that apply.

Please explain the details below.

Special Education Programs
Has your child been qualified to participate in any special programs? Please check all that apply.

Please provide additional details here.

If your child has an Individualized Education Plan, a copy of the IEP will be required upon starting school.

Language first spoken
Other Special Ed (explain)
Siblings of Student
Please list other children in the family
  Full Name Age Grade Entering Fall 2009
1
2
3
4
Additional Information (Optional)
If you wish, you may provide additional information here.
Please check your work carefully and, when you are ready,
click "Submit Enrollment Application."
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