Fill out the
Application
for Admission

Congratulations!

We have met, you have discussed your options, and we interviewed both you and your son to see if Gladiator Academy is a fit. Now you are continuing to the next step in the process of admission. This is the application process.

We want to let you know that this application will solely be used for our purpose in the Academy. The information you enter into this form is secured in our severs and will never be sold or disclosed to anyone outside of Gladiator Academy.

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Looks like you are using a mobile device or tablet. Due to the nature and design of the form you cannot fill out this form from a mobile device or tablet it must be a desktop.

Please keep in mind this is a multi-step application. We do not save any data for you to return due to security reasons. Please allot at least 30 minutes to complete the form in one sitting.

Student Name

Student Nickname

Student Date of Birth

Student Age

Student Height

Student Weight

Choose LAST grade completed

Current Student Scholatic Enrollment

Student Current Grade level

Student expected Grade level

Current GPA

Student Cell phone #

Student Email

Name of Father

Name of Mother

Last Name

Parent, Guardian, or Responsble Parties Name (Primary)

Relation to Student

Best Contact Ph#

Primary Contact Email Address

Parent, Guardian, or Responsble Parties Name (Secondary)

Relation to Student

Best Contact Ph#

Secondary Contact Email Address

Address

City

State

Zip Code

Type of Contact

Phone number

Emergency Contact Name

Emergency Contact Number

Family Status

IF parents are divorced which parent has guardianship/custody?

Who has educational custody?

Student RESIDES with:

If Other - Who?

Does student have "step-parents"?

Are there SIBLINGS in the home?

If SIBLINGS reside with student please enter Names and Ages

Names of any other person (step sibling or adult aged) who reside in the home with student (full or part time)

Describe Students present PHYSICAL health

Describe Students present EMOTIONAL health

Describe Students present SPIRITUAL health

Describe and then RATE the level of your son's satisfaction with his current life.

Scale

Speech Difficulties?

Speech Therapy?

Licensed Counseling?

Learning Disabilities?

Special Education Class(es)?

Failed Grade of left Behind?

Does Student have any academic and/or development needs that we should be made aware of to more effectively Assist in your son's performance? (if yes please explain - if none - enter none)

Does Student currently have or ever have an IEP, 504 plan or any professionally diagnosed modification to classroom instruction? (if yes please explain - if no enter none)

Has the student had or have attendance/tardiness problems? (if yes please explain - if no enter none)

Has the student ever been suspended from school (inschool or out of school) (if yes please explain - if no enter none)

Has the student ever been expelled or refused admission to another school? (if yes please explain - if no enter none)

Does the student use alcohol, tobacco, vape or any non-prescription drugs? (if yes please explain - if no enter none)

Has the student had any legal problems past or present? (if yes please explain - if no enter none)

Has the student ever been arrested? (if yes please explain - if no enter none)

Has the student ever been convicted of a sexual or violent offense? (if yes please explain - if no enter none)

Does the student have any physical limitations? If yes please explain, if no please enter none

Allergies?

Please elaborate as to allergies (if applicable)

Eating Disorders?

Please elaborate as to eating disorders (if applicable)

History or seizures/blackouts?

Please elaborate as to seizures/blackouts (if applicable)

Check and of the following that apply to the student applying for admission

Is there anything else we should know about the student that is not listed in prior questions?

In this final question of the application please take a moment and think and share with us any interests, hobbies, talents, strengths and abilities your student may have. This is where you can tell us some good stuff about your student.

Interests PLUS

Insurance Agreement

I certify that I understand that I cannot file for reimbursement of any medical expenses on behalf of my child while attending Gladiator Academy. Any injuries that may occur while taking part in any activity while at Gladiator Academy or during any excursion sponsored by Gladiator Academy will be covered solely by my personal insurance and/or any other institutional insurance coverages. In the absence of any coverage I understand that I will be liable for ANY medical charges.

ACCEPTANCE

By filling out this application I affirm I am a legal guardian of the student described in this application. I further affirm that I am authorized to enter into contract with Gladiator Academy for the scholastic year(s) that my son will attend. I affirm that I am in agreement with Gladiator Academy Terms and Conditions; Student Requirements, and code of conduct. The checking of this box indicates and substitues required signature.

The form is not published.

We are not an alternative school but an alternative form of education.

We are NOT an alternative school but an alternative form of education.

Fill out the
Application
for Admission

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Fill out theApplicationfor Admission

SORRY!

Fill out the
Application
for Admission