Campus Student Application - Wellmont Academy

School Information

Desired School Entrance Date*

Has student previously attended Wellmont Academy?*

If answer to question above was "yes", what year did student withdraw?

Do other siblings attend Wellmont Academy at this time? If so, please list their names and grades.*

If none, type N/A.

Names and Ages of other school-aged siblings who do NOT attend Wellmont Academy at this time.*

If none, type N/A.

School Attendance History*

School Name	Date Started Attending	Length of Attendance in Years

Please list all previous schools that your child has attended.

Previous school physical address and admissions office email address and contact person*

We will need this information to request records for your incoming student. If you are a homeschool family, please place parent email information here.

Private or Flex Student Enrollment*

I plan on signing up my child as a Privately enrolled student.
I plan on signing up my child as a Flex student.

Are you interested in signing your student up as a Private or Flex student with us? Privately enrolled students enjoy the following benefits: We keep track of all records, including grades and transcripts; year-end testing is included in your fee; private students are eligible to receive free guidance counseling from our school guidance counselor; private students are eligible to receive a high school diploma upon graduation. *The cost for Privately enrolled student services per year is $250. Flex students are eligible to receive a homeschool high school certificate upon graduation.

Have you currently received or do you plan on applying for a scholarship award? Please check all that apply*

Yes, I have or am currently applying for a scholarship.
No, I plan on private pay

Please check all scholarships that you are applying for or have already recieved an award letter for.*

Select All
Gardiner Scholarship
FL Tax Credit Scholarship
FES Scholarship
HOPE Scholarship
Private funding scholarship if available

Evaluations and official documents

Recent Evaluation Score, Standardized Assessment or Report Card

Drop files here or

If available, please attach a copy of the student's most recent Evaluation, Test or Report Card to determine placement. This helps us better serve your student. If you are unable to provide adequate documentation, your student will be required to complete an standardized assessment, administered by Wellmont's Testing Department, prior to enrollment, for an additional fee of $75.

Copies of birth certificate, health form (less than 2 years old), and current immunization form DH680 or religious or medical exemption for immunizations.

Drop files here or

If available, please attach a copy of the student's birth certificate, current health form, and either a current immunization form DH680 or a medical or religious immunization exemption for their records. Because we are a private school in the State of Florida, these documents are required for your student's school file.

Notices of Values and Rights

Application Process Agreement*

Upon receipt of this application, we will call you to schedule a family interview with a member of our staff. Acceptance to Wellmont is determined by our staff and is a matter of prayer. We will notify you of acceptance via email, beginning March 1st. Do you agree to this application process?

Registration Fee Information*

If your family is accepted to Wellmont, you will be able to pay your registration fee of $250 to hold your child's seat. After your registration fee is paid, you will receive a "welcome" email as well as a login to your parent portal with directions for completing the rest of your paperwork and registering for your child's classes. Your registration fee MUST be paid to hold your child's seat. Do you understand and agree to these terms and conditions?

Family Values Statement*

In a society of shifting values, Wellmont Academy chooses to use the biblical standard for evaluating and defining the family. We recognize marriage as a covenant between one man and one woman, and we believe that the responsibility for helping children to see their God-given identity, as defined by the Bible, rests primarily with the family. Our school is a support network for these values, not the primary influence of Christian character for your child. Your child WILL be taught to recognize and abide by Christian values at school. At home, it is also essential that your child be taught and that you model Christian principals and God-given identity for them in order for them to be successful at Wellmont Academy, including agreeing to find and attend a bible-believing local church. Do you agree to abide by this standard of Christian behavior and to hold up this standard at home?

Agreement to abide by the rules of Wellmont Academy*

As parents and prospective students, we agree to abide by the rules of Wellmont Academy. We understand that at any time, for any reason, Wellmont may choose to terminate our student's enrollment, making all payments and fees non-refundable if they see fit.

Notice of Rights

Wellmont Academy of Tampa Bay, Inc. admits students of any race, color, national and ethnic origin to all the rights, privileges, programs, and activities generally accorded or made available to students at the school. It does not discriminate on the basis of race, color, national and ethnic origin in administration of it's educational policies, admissions policies, scholarship and load programs and athletic and other school-administered programs.

Application Fee*

Price: $25.00

Credit Card*

Card Details

Cardholder Name

Email

This field is for validation purposes and should be left unchanged.

Student Application for K-12 Campus

Step 1 of 6

Student Information

Address Information

Parent/Guardian Information

References

Emergency Contacts

Medical Information

School Information

Evaluations and official documents

Notices of Values and Rights

Notice of Rights