Parent/Guardian Information


Student lives with (check all that apply):  Mother    Father    Stepmother
    Stepfather     Guardian      Other (specify):

If relevant, please indicate to whom and where an additional copy of all correspondence should be sent:

Name:  

Address (line 1):  

Address (line 2):  

City:      State:     Zip:

 

Information about (check one): Father     Stepfather     Guardian

Name:  

Home address, if different (line 1):  

Home address, if different (line 2):  

City:      State:     Zip:

Home phone, if different:      Cell:  

E-mail address:  

 

Information about (check one): Mother     Stepmother     Guardian

Name:  

Home address, if different (line 1):  

Home address, if different (line 2):  

City:      State:     Zip:

Home phone, if different:      Cell:  

E-mail address:  

What resource(s) did you use to learn about Freedom Mountain Academy?
Independent education consultant:  Name:
Internet site:  Name:
Current or former FMA student:  Name:
Other (please specify):  Name:  
 
After filling out this page print it and return it with other forms.