Enroll – English Tucson International Academy Enrollment / Registration 2024-2025Date of Registration MM slash DD slash YYYY Site Broadway Midvale West Remote Learning Enrolling for Grade Student's Name First Middle Last Date of Birth MM slash DD slash YYYY Address Street Address City State / Province / Region ZIP / Postal Code Home PhoneCell PhoneDay PhoneGender Is the information above the same as the previous school year? Yes No How did you hear about TIA? Newspaper TV Social Media Radio Other Referral From Ethnic Choice: (Optional) Please check the one that you most identify with Hispanic (Mexican, Latin American or another Spanish origin) White (not of Hispanic origin) Asian or Pacific Islander (Oriental) Black (not of Hispanic origin) Native American Indian or Alaskan Native Decline to Answer Last School Attended Grade Address PhoneThis information is solely used for ensuring the continuation of services for programs and will not be considered in making enrollment decisions.Number of children in family Does the child live in a foster home?(Optional) Yes No Decline to Answer Group Home?(Optional) Yes No Decline to Answer Father's Name Father's Phone Father's Email Mother's Email Mother's Phone Mother's Name Step-Parent's Name Step-Parent's Phone Step-Parent's Email Legal Guardian's Email Legal Guardian's Phone Legal Guardian's Name Is there a non-custodial parent? Yes No Student is living with Brothers Brothers Date of Birth Brothers Brothers Date of Birth Brothers Brothers Date of Birth Sisters Sisters Date of Birth Sisters Sisters Date of Birth Sisters Sisters Date of Birth Emergency Contact Name Emergency Contact Relationship Emergency Contact Phone Contact First? Yes No Emergency Contact Name Emergency Contact Relationship Emergency Contact Phone Contact First? Yes No Is the student a dependent of a member of the United States military service in the Active Duty military (Army, Navy, Air Force, Marine Corps, Space Force or Coast Guard) or a dependent of a full-time member of the National Guard or Reserve forces of the United States military ( Army, Navy, Air Force Marine Corps , Coast Guard or Space Force). Yes No Decline to answer Is the student a dependent of a non-full-time member of the National Guard or Reserve forces of the United States military (Army, Navy, Air Force Marine Corps , Coast Guard or Space Force) Yes No Decline to answer Was the student expelled or in the process of being expelled from previous schools attended? Yes No If yes, explain:This information is solely used for ensuring the continuation of services for programs and will not be considered in making enrollment decisionsWas the student enrolled in any of the following programs (check all that apply): SPED (IEP) Speech EL (English Learners) 504 Plan Other Other: I have received a copy of the Parent and Student Handbook Yes No My Signature below certifies all the following: 1.) I am the parent/legal guardian of this student. 2.) All information given above is correct to the best of my knowledge. 3.) Tucson International Academy (TIA) has my permission to obtain school records from the schools attended. TIA reserves the right to honor another school’s expulsion. Students who have been expelled or are in the process of being expelled will not be enrolled at TIA schools.Required documentation due at time of enrollment: Proof of Residency: Arizona law requires us to obtain and maintain verifiable documentation of Arizona residency upon enrollment. Documentation that may be accepted is set forth on the Arizona Residency Documentation Form in this application. Home Language Survey: The Arizona Department of Education requires us to obtain a signed copy of this document at the time of enrollment. WITHIN 30 DAYS OF THE DATE OF ACCEPTANCE, the following documents must be provided by parents: Birth Certificate or other reliable proof of the student’s identity and age: If you do not have your child’s birth certificate, please contact us for information about the other legally acceptable documents for proving the student’s age and identity. UPON ACCEPTANCE, AND PRIOR TO STUDENT’S FIRST DAY, the following documents must be provided by parents or the student’s previous school, unless the student is homeless Immunization Records: All students entering Arizona schools are required by law to be immunized prior to the start of classes. Proof of immunizations (printed from your doctor’s office or other documentary proof) or a signed waiver is required. A waiver form is available from the School should you require one Withdrawal Form: from previous school Signature
