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K-8th Grade
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WHITE PINE ACADEMY
Home
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Mission Statement
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K-8th Grade
White Pine Academy
Application For Admission (K-8th Grade)
Student Information
*
Indicates required field
Name
*
First
Last
What is the student's first and last name?
Grade Level Applying For
*
Kindergarden
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
What grade will the student be going into? If the student is enrolling in Preschool, please see the Preschool Application Page on our website.
Present Grade Level
*
Preschool
Kindergarden
1st
2nd
3rd
4th
5th
6th
7th
8th
What grade is the student currently enrolled in?
Age
*
What is the student's current age?
Date of Birth
*
Place of Birth
*
Address
*
Line 1
Line 2
City
State
Zip Code
Country
If there is more than one address, please list the primary address that the student will use when attending school.
Home Phone Number
*
Emergency Contact Person
*
Name of individual
Emergency Phone Number
*
Email
*
Parent/Guardian
Immunizations Up to Date
*
Yes
No
Has the student ever been suspended from school?
*
Yes
No
Has the student ever been expelled?
*
Yes
No
If you replied "yes" to either question, please explain below:
*
If this does not apply, leave blank.
Does the student receive Special Education services or have an IEP?
*
Yes
No
If you replied "yes" please provide details below:
*
If this does not apply, leave blank.
Parent/Guardian Information
Father/Guardian's Name
*
First
Last
Present Address
*
Line 1
Line 2
City
State
Zip Code
Country
Father/Guardian
Phone Number
*
Father/Guardian
Mother/Guardian's Name
*
First
Last
Present Address
*
Line 1
Line 2
City
State
Zip Code
Country
Mother/Guardian
Phone Number
*
Mother/Guardian
If you affirm the above information to be true and accurate Initial and Dare the lines below.
Initial
*
Date
*
Submit
Prefer a paper copy? Download one below:
K-8 Application for Admission
Principal: Marianne Dege
Phone: 517-589-8961
Fax: 517-589-9194
510 Russell Street, Leslie, MI 49251
Home
About Us
Mission Statement
Staff Directory
Staff Professional Development
Board of Education (BOE)
>
BOE Minutes
Annual Education Reports
School Safety
School Improvement Plan
Technology
Freedom of Information
Parent and Student Resources
Parent Resources
Kindergarten Registration
Student Resources
School Calendar & Activities
After School
Lunch Program
Title IX
Apply
K-8th Grade