WPC S+ KYmnX솂/T]ë )AG=;vc Aj\v*Ո+Ǔdc& d'q_zyiʗ`5a~/k<'Xkee1C9l\6H|1A&rX5h%L]֨g`QCHk*+^HNgJ%ւj+kvxX)}=P꡷^C[,^^iؒ2;?  }ep׾HfxB(&*s%y(U#xB/qs lL;QY vi dI_HIڭv{Y*r~Lښ 8(y9r'#X%  ;7ڗ֧5pӝbZXH.k#4ZL̉l8(bZUj ![:on6#n,&#ɓz+U0Z % Cfa B* B%^ #NwUH* m,,4CCCCCCCW 04gggggggggggggggggg BB) `CG TimesX dTable_A&0 d d dI4 \\HP\HP,,,,0%M0 Z 0YeOldEnglish RegularUФ903|+( T$  >Thick DoubleK d d T!   _,,,\ uXX du 9 dNoahWebsterAcademy#r 9# #ur#pp|& APPLICATIONFOR_ADMISSION _Ԉ ,  uu 6707PeckLakeRd._Saranac_,MI.48881<<|&# u#Telephone:(616)6420564Fax:(616)6420568 d  , , Nondiscriminatorypolicy:NoahWebsterAcademyshallbeopentoallstudentsregardlessofreligion,creed,race,colorornationalorigin.   I#  ,,#, , NSTRUCTIONS:PLEASETYPEORPRINTININK.THESCHOOLYEARRUNSFROMJULY1STTOJUNE30THEACHYEAR.#  ,,# pD * ,ddd Xdd Xdd X,|&,|&, d ,N d ,d ,d ,d +  5" xx5   STUDENT&FAMILYINFORMATION QB/`4  xx   0QStudent'sLastNameFirstNameMiddleInitial vJ  5&  5_Birthdate_ 2#vJ  2GradeEntering 6#vJ  6Sex:M/F E6#vJ  0  0EStreetAddress P$   5& ` 5City 2#P$ 2County 6#P$ 6Zip E6#P$ 0  0EFamilyLastName *   C4) v  CMother(femaleguardian) *   :'  :HomeTelephoneNo. *   C9&  0  0C &   &Father(maleguardian) :'  :WorkTelephoneNo.    H9&S '  0  0HFather'sEmployer&Occupation @    =*|P ! =Mother'sEmployer&Occupation @  "  H9& # 0  HNames&GradesofOtherChildrenEnrolledin_NWA_  $ 1.2.3. =*V*& =EthnicBackground L9& '   xxL @mSCHOOLINFORMATION H9&l@( xx   "HName,Address,City,State&ZipoflastSchoolattended. V) (Pleasecheck)&Public&Private&Home =*6 / =IfHomeSchooled,StateName&AddressofLastPublicSchool V0 Attended  1 LastGradeCompleted H9&6 6 "  HPleasecircle"Yes"or"No"foreachofthefollowingquestions.If"Yes,"followthe 7 instructionsgivenafterthequestionandplaceyouranswerintheadjacentexplanationbox. rF8 &Yes&No0 ` IstheStudentcurrentlyenrolledinotherpublicschoolclasses?If"Yes" L ; pleaseidentifyschool,classes,andhoursinattendance.<`+`+ &Yes&No0 ` IstheStudentcurrentlyworkingduring"regular"schoolhours?If"Yes" &> pleaseidentifyemployerandhoursemployed.?`+`+ &Yes&No0 ` DoestheStudenthaveanyphysicallimitationsthatthePEInstructor A shouldbeawareofpriortoengagementinphysicalactivity?If"Yes" rB pleaseexplain.<C`+`+ &Yes&No0 ` HastheStudentbeenidentifiedashavingaspecificeducational xLE impairment?If"Yes"pleaseidentify. F`+`+ . =* G =Explanation H Ӏ K Ѐ \N ЀӀ b6Q ̀ <T  L9&xLV  xxL @##nPARENTAGREEMENT L9&! W xx   Lu IunderstandthatasaparentvolunteerIamrequiredto:1)bepresentoravailableduringallstudyhours;2)provideaquietareato d#8"X study;3)monitoralltests;4)planorassistinplanningdailystudytimes;5)performdutiesasspecifiedincommunicationsfromNoah .$#Y WebsterAcademy;6)mailcompletedworkasrequiredbytheAcademy;7)informtheAcademyimmediatelyofanyvacations,address $#Z changes,orchangedcircumstances;8)mailinsemesterattendanceandacademicreportsbyJanuary15andMay31foreachsemester's %$[ work;9)askforteacherassistanceorsuggestionsifdifficultiesarise;and10)providetheAcademywithnationallystandardized &`%\ achievementtestresultsifwechoosenottoparticipateintheAcademy'stestingprogram. V'*&] Iagreetomonitorthestudentnamedaboveingrade򀀀.G&򀀀 ('_ , ,u88)c()(ԀParentvolunteer'ssignatureu ,,%)()c( )(` Parentvolunteer'srelationshiptostudent:򀀀 ,*)a Parentvolunteer'shighestdegreeorgradelevelcompleted:򀀀 +*c  uPleasecircle"No"foranyofthefollowingyoudonotwant: T-(,e ̀&No_NWA_Ԁmayplacemychild'snameinastudentdirectory. .d-g Ѐ&No_NWA_Ԁmaypublishmychild'sworkinanewsletter.fG&s-u,./.Ԁ-/.-u,Ԉ -/.h ,,,||/z./., , s.,/z.Signatureofparentorguardian(ifdifferentfromparentvolunteer)#  ,,#/z.., /z.i /.0.Ԁ&No_NWA_Ԁmaysendmychildbirthdayorholidaygreetings.I0./. 0.j Dateofapplication:򀀀fG&?/.0/Ԁ /.k ,,,||t0H/0m/, , ԀSignatureofparentorguardian#  ,,!#+0.t0H/ +0.l 6,*A10n   6