Admissions Form
1 Step 1
LATV Admissions Application
Child's Information

*Students are required by the Missing Persons Act to provide a birth certificate and/or social security number to verify identity

Has the student ever had an educational assessment, performed by a school or outside professional, to determine any learning differences?

Has the student ever been referred to a psychiatrist, psychologist, licensed professional counselor, psychiatric social worker, or other mental health professional, for emotional, psychological, or social reasons?

School Information
Pre School
Pre School Choice
1st Choice2nd Choice3rd Choice
Full Time
Family Information

1st Parent or Guardian

2nd Parent or Guardian

Status of Parents
With whom does student live during the school year?
Additional Information
Early Withdrawl Agreement


Early Withdrawal AgreementI understand that by registering my child to attend school at The Learning Academy and by paying a non-refundable deposit, a space will be reserved in the applicable class specifically for my child. I understand that registering my child without enrolling him/her or withdrawing during the school year will cause difficulty, as student spaces cannot or may not be filled. I also understand that as an independent school, The Learning Academy’s budget is based largely on tuition revenues and contributions.


Therefore, I specifically agree that once my child is registered and guaranteed a space, if my child is withdrawn or dismissed for any reason, I am obligated to forfeit the return of my deposit and disperse an additional month’s tuition in their absence. If I am the recipient of a scholarship or financial aid, I will be required to repay the difference between the actual tuition and the assisted amount for the entirety of my child’s tenure so that this granted amount may be offered to a family who will use the aid in sum.


This contract is valid, acknowledged and enforceable for the term of my child’s enrollment at The Learning Academy. If any portion of this contract is found to be unenforceable by a court of law, then the remainder of said contract shall remain in full force and effect.


I have read and agree to abide by all financial policies set forth for the term of my child’s enrollment at The Learning Academy. In the event that tuition or fees remain in arrears, I understand that LATV & L.E.A.R.N retain an attorney or collection agency to collect monies due and I am responsible for reasonable attorney’s fees or collection agency costs.

Statement of Commitment

By signing below I verify that all above information is accurate to the best of my knowledge and that I will notify The Learning Academy in the event that there are changes to this information. I permit the school to use print and electronic photographs of my student taken during school activities to promote The Learning Academy and its programs. Additionally, I have reviewed the informational packet, including the philosophy and mission. I agree to support the school and its goals and understand that I am responsible for participating in my child’s education by reading all school-related literature, helping with homework and ensuring that my child eats nutritiously and gets adequate sleep. I understand that the cost to educate my child at The Learning Academy exceeds my tuition payments and I will be responsible for offering help with fundraising and other school-related activities. The following signature denotes that I have read and fully understand the commitment my family is making to The Learning Academy.

SignatureI agree to the terms and conditions
(Sign With Mouse or Finger)
Clear Signature