Enrollment Application

E3 Academy

Please fill out the Enrollment Application below. Ensure all student information and institutional policies are fully reviewed before submitting

Application for Enrollment 2026-2027

Student Information

Student's Full Name *

Preferred Name

Street Address *

City *

ZIP Code *

Main Phone Number *

Date of Birth *

Age (as of Aug 1, 2026) *

Gender *

Student Lives With (Check One) *

Both Parents

Mother Only

Father Only

Someone other than parent

Please specify who the student lives with: *

Family & Academic Background

If your family is new to E3, how did you hear about us?

Reason for Applying *

Information that could be helpful to our faculty in working with your child:

Previous Academic History

Previous School Attended

City

State

Zip

Siblings Attending E3 in the Same School Year

Sibling Name

Grade

Parents or Guardians

Parent / Guardian 1

Full Name *

Relationship *

Church Affiliation

Occupation

Company Name

Home Address (If different from student)

Cell Phone *

Work Phone

E-mail Address *

Emergency Contacts (When Parents Cannot Be Reached)

Emergency Contact 1

Emergency Contact Full Name *

Relationship to Student *

Phone 1 *

Phone 2

Address *

E3 Academy