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All items with an asterisk(*) are required.
If you have any questions or concerns while applying, please call our administrative offices at 248-745-9420.
Once the enrollment form is submitted you will be contacted for any additional information and documents required prior to final admission.
Has your child already attended Pontiac Academy for Excellence? To RE-ENROLL please click here
Alternate Last Name
*Ethnicity---African-AmericanAmerican Indian/AlaskanAsian AmericanCaucasianHispanic/LatinoNative Hawaiian/Pacific Isl.Multi/Bi-racialOther
*Is your child's native tongue a language other than english?YesNo
If yes, what is that language?
Primary language(s) spoken at home?
*Does your child attend a day care center or go to a sitter after school?---YesNo
*I wish to enroll my child in---ElementaryMiddleHigh
*Has your child ever attended school before?---YesNo
*Will your child require any of the following education services?Special education (IEP)BilingualNo special education services
*Phone Number where child resides
Address where child resides
*City: *Zip Code:
*Adult MALE Parent/Guardian
*Adult FEMALE Parent/Guardian
Please Fill in the text field below following the guide provided for all siblings that live in the same residence as the enrolling student:Sibling Name: <Name>
Sibling Birth Date: <Birth Date>
Sibling Grade: <grade>
Sibling Attending PAE?: <yes/no>
*Emergency Contact Person
*Emergency Medical Conditions/Problems:
Please check ALL that applyNothing knownIodine AllergyWears glassesMedical waiverMulti-allergyBee stingRheumaticEpilepticAsthmaCardiacContact lensesNose bleedsHemophiliacSpecial blood conditionNo medication, religiousDiabeticSulfa allergyCheck health cardAspirin allergyMuscle weaknessAttention deficit disorderPenicillin allergyHeadachesHearing problemsNone
*Will your child be taking medication during school hours?YesNo
If yes, a "Permission Form for Prescribed Medication" will need to be completed by parent/guardian and Physician. Forms are available in the Office.
It is important for my/our child to achieve. Therefore I/we will encourage my/our child by doing the following:
Your child is on their way to becoming a lively part of the Pontiac Academy for Excellence community. Will you authorize us to use photo or video of your child to promote our school district?
I fully consent to and give Pontiac Academy for Excellence full authority to use in its discretion any and all media material containing my child's information (including but not limited to name, image, story, life circumstance, and/or data) and/or such information of any person for whom I am the legal guardian. I understand that this consent is full and absolute and I hereby give Pontiac Academy for Excellence the right to publish all such media materiel in every form possible including in agency promotional material, to distribute it directly or indirectly to the media at large, and/or post such material on Pontiac Academy for Excellence's website or any social media web pages.
Without limiting the generality of the above consent, I specifically authorize Pontiac Academy for Excellence to use the material indicated below in the manner stated above, subject to any specific limitation indicated below:
*I will allow:PhotoVideoStory (parent will be consented again before story is released)First nameLast nameNone
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