Application

Apply to Fieldstone Academy

Thank you for your interest in our school. Please fill out the application below. This form collects the relevant information we need to make a preliminary decision. If your student is accepted, we will request additional paperwork and verification, including transcripts, immunization records, and insurance information.

Student Information

First Name (required)

Last Name (required)

Country of Citizenship

Date of Birth

Current Grade Level

Street Address

Please leave this field empty.

City

Zip

Parent/Guardian Information

Primary Guardian First Name (required)

Primary Guardian Last Name (required)

Email (required)

Best Phone Number

Other Phone Number

Street Address (if different than student)

City

Zip

Secondary Guardian First Name

Secondary Guardian Last Name

Email (if applicable)

Best Phone Number

Other Phone Number

Street Address (if different)

City

Zip

Current School Information

School Name

School Fax Number

Counselor Name (if applicable)

School Phone Number

Other Information

Please describe, in your own words, your student's academic strengths and weaknesses:

Is there anything else we should know about your student's behavior or situation?

Please list any medications your student is taking, also include any food allergies we should be aware of: