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Pre-Enrollment Questionnaire Grades 9-12

Pre-Enrollment
Questionnaire Grades 9-12

Completing our pre-enrollment questionnaire does NOT obligate you to attend. Once completed you will receive a confirmation page, and we will contact you to discuss an independent learning program with an individualized curriculum.

Royal Academy Educational Questionnaire Grades 9-12

Step 1 of 5 - About your Student

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Today's Date*
MM slash DD slash YYYY
How did you hear or learn about Royal Academy?*
Programs of interest. Check appropriate box(es)
- Enrollment
- Virtual School
- Program Design
Child's Full Name*
First Middle Last
Gender*
- Male
- Female
Child's Date of Birth*
MM slash DD slash YYYY
Age (Today)
Grade in this school year
Parent or guardian name*
First Last
Parent or guardian occupation
Complete Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Email*
Highest grade completed in HOME EDUCATION only, or skip to public or private school
Highest grade completed in PUBLIC SCHOOL only, or skip to private school section.
Highest grade completed in PRIVATE SCHOOL only.
Has your child been diagnosed as learning disabled?*
- Yes
- No
If your child has been diagnosed as learning disable, please describe the diagnosis and attach copies of reports, test results and the most recent IEP.
Upload reports, test results and most recent IEP (Individualized Education Plan)
Max. file size: 512 MB.
Is your child receiving special help such as physical therapy or speech therapy? If yes, please describe.
Who will be the primary tutor for this child?
How does your child feel about learning? About school?
Does your child have special talents, hobbies or interests? Please list.
What does your child want to learn about this school year?
What 2 to 3 goals do you have for your child this school year?
Please provide a list of resources (books, videos, human resources, etc.) readily available to you and your child.
Please provide a list of your child's strengths and weaknesses.
Include a copy of the most recent report card and transcript with this questionnaire
Max. file size: 512 MB.
Please upload a recent photo of your child.
Max. file size: 512 MB.

This page to be completed by parent or guardian.
Please answer the following questions with as much detail as possible.
What are your child’s plans for post-high school?
How are you planning to help accomplish these plans?
Does your child intend to enroll in college?
- Yes
- No
Does your child intend to enroll in a trade school (business or vocational)?
- Yes
- No
Does your child want to enter the military?
- Yes
- No
If the answer to any of the above was yes, have you contacted the appropriate admissions people yet?
- Yes
- No
What year do you think your child will complete high school?
What has your child done for service work (volunteer work) and for how long?
What are his/her interests and hobbies? How does he/she pursue them?
Have you traveled much as a family?
- Yes
- No
If yes, where? When?
Are you planning to enroll your child in Royal Academy for all of high school?
- Yes
- No
- Uncertain
If not, where will the high school years be completed?
Has your child been employed? What types of jobs have been held?

About the courses you would like your child to take this year:
English (specify special interests)
Mathematics
- Algebra
- Geometry
- Business Math
- Consumer Math
- Precalculus
- Other
Social Studies / History
- History (specify culture or time period)
- Geography
- State Study (specify state)
Please provide some detail on specific cultures, time periods or states of study.
Science
- Biology
- Chemistry
- Psychology
- Ecology
- Physics
- Childhood Growth & Development
- Zoology
- Health
- Other
Fine Art
- Drawing / Painting
- Music
- Dance
- Theater
- Other
Health (please specify)
Physical Education
Foreign Language (please specify)
What areas, if any, are difficult for you to teach?
Will you need a tutor to help in any of the above areas?
- Yes
- No
Which areas might you need help tutoring?

This section to be completed by the student.
What are your plans for post-high school?
How will you accomplish your future plans?
Do you intend to enroll in a trade school?
- Yes
- No
Do you intend to enroll in a college?
- Yes
- No
Do you intend to enroll in the military?
- Yes
- No
If the answer to any of the above was yes, have you contacted the appropriate admissions people yet?
- Yes
- No
What year do you do you want to complete high school?
What have you done for service work (volunteer work) and for how long?
What are your interests and hobbies? How do you pursue them?
Have you traveled much?
- Yes
- No
If yes, where/when?
Are you planning to enroll in Royal Academy for all of high school?
- Yes
- No
If not, where will your high school career be completed?
Have you been employed?
- Yes
- No
What types of jobs have you held?

Areas you would like to study this year.
English (specify special interests)
Mathematics
- Algebra
- Geometry
- Business Math
- Consumer Math
- Precalculus
- Other
Social Studies / History
- History (specify culture or time period)
- Geography
- State Study (specify state)
Please provide some detail on specific cultures, time periods or states of study.
Science
- Biology
- Chemistry
- Psychology
- Ecology
- Physics
- Childhood Growth & Development
- Zoology
- Health
- Other
Fine Art
- Drawing / Painting
- Music
- Dance
- Theater
- Other
Health (please specify)
Physical Education
Foreign Language (please specify)
Are there any courses for which you would prefer to have a tutor?
- Yes
- No
- Not Sure
If yes, which course(s)?
Parent Signature (type your name here to serve as your electronic signature)
Student Signature (type your name here to serve as your electronic signature)
Thank you for completing this questionnaire.
Name
This field is for validation purposes and should be left unchanged.

Contact Us

Royal Academy Education
in process of moving to:
16 Rockwood Drive
New Gloucester, ME 042606

Mailing Address
PO Box 1056
Gray, ME 04039-1056

Payments Mailing Address
PO Box 757
Chester, VT 05143

Phone
(207) 831-5337 Penny
(207) 572-2927 Julie
(207) 572-2928 Bern

Email [email protected]

Office Hours

Monday — Friday: 9:00am – 4:00pm
(winter hours) or call for appointment.

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