Online Application

Program for which you are applying*
Pre-Primary 2 days/weekPre-Primary 3 days/weekPre-Primary 5 days/weekPrimary MorningsPrimary Mornings + AfternoonKindergartenElementary 1st GradeElementary 2nd GradeElementary 3rd GradeElementary 4th GradeElementary 5th Grade

How did you hear about AIA?*
School WebsiteFacebookWeb SearchReferral from friendReferral from familyReferral from staffDrove by locationOther

Childs Information

Child’s First Name*

Child’s Middle Name*

Child’s Last Name*

Child’s Preferred Name*

Child’s Gender*
MaleFemale
Child’s Date of Birth (MM/DD/YYYY)*

Child’s Place of Birth*

Child’s Home Address (Street, City, State & Zip)*

County of residence*
FultonCobbGwinnettForsythCherokeeOther

Father's Information

Father’s Full Name*

Father’s Phone (cell)*

Father’s Phone (work)*

Father’s Phone (home)*

Father’s E-Mail*

Father’s Occupation*

Father’s Name of Employer*

Mother's Information

Mother’s Full Name*

Mother’s Phone (cell)*

Mother’s Phone (work)*

Mother’s Phone (home)*

Mother’s E-Mail*

Mother’s Occupation*

Mother’s Name of Employer*

Other Information

List names/ages of siblings living at home*

Does your child speak/understand English?*
YESNO
If other languages are spoken in your home, please list below

Describe the general health of your child*

Does your child have any allergies?*
YESNO
If yes, please explain
Are there any health or development concerns that you wish to share?

Are there any special circumstances or situations that might impact your child’s learning?

Briefly describe your child’s personality*

Briefly describe your child’s interests/hobbies*

List previous schools your child has attended*

Ethnic Origin (optional)

Religion (optional)

Church Affiliation (optional)

Additional Information

Message*