Enrollment | RVAA

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OUR SCHOOL
ACADEMICS
PROGRAMS
ADMISSIONS
- Tuition and Fees
- Enrollment
RESOURCES
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Enrollment Application

NOTICE: These forms will take some time to fill out. Please plan accordingly.
There are two pages that you will be summiting,

student page and Parent/Guardian page.

Please fill out both Pages.

Student Information

A copy of Birth Certificate and up-to-date Immunization Records must be on file before a child can attend/enroll in school.

Student's First Name

Personal

Student's Last Name

Gender *

Female

Male

Date of Birth

Age

Place of Birth

US Citizen *

Yes

Student's Address

Student's Address Line 2

City

State

Postal / Zip code

Student's Cell

Student's Email

Baptized? *

Yes

If Yes, where?

Student's Current Church Membership

Student's Health Concerns

Medical

Does your child have physical conditions that would hinder him/her from carrying a full academic load? *

Yes

If Yes, help us meet your childs needs by sharing details below:

Physician

Physician's Phone Number

Entering Grade

Academic

Kindergarten & Pre-K

Half Day

Full Day

School Year

Student's Last Attended School

Date of Attendance

Is your student currently expelled or suspended from another school? *

Yes

If Yes, help us meet your childs needs by sharing details below:

Does your student have an IEP? *

Yes

If Yes, please submit a copy to the Registrar

NOTICE: please have your child read and digitally sign

I have read the objectives and policies of this school. If I am accepted by the school, I will endeavor at all times to uphold the Christian standards of the school and to respect the staff and the rules.

Student Contract

Student Signature

please enter your name in lieu of a signature

Date of Signature

Adventist Academy

Tel: (541) 773-2988

Email: info@rvas.org

Address

3675 S Stage Rd

Medford, OR 97501

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