Application

Our first step in the application process is to tour and meet with all prospective families. From there, we will meet for a family interview, have your learner visit for trial days, and finally to share admission status. As part of your admissions information, we require the completion of this application along with a $175 application fee and additional documents listed below. Questions? Email info@illuminateacademy.org 

We are excited to learn more about your family!

 

Please complete the form below

Name *
Name
Child's Gender
Please Provide: Relationship to Child, phone, Email, address and occupation
Please Provide 2
Martial Status
With Whom Does the Child Reside
Does the child have regular visitation with a non-custodial parent?
Does your child have any siblings?
Is there anyone else (family, friends, etc.) regularly involved in your child's care?
Date of last medical Check up or Physical
Date of last medical Check up or Physical
Is your child in good, general health?
Has your child experienced any of the following medical conditions?
Check all that apply
Is there a family history of any of the following? Please check all that apply:
Has your child ever been admitted to a hospital for psychiatric, behavioral, or crisis situation?
Most recent hospitalization:
Most recent hospitalization:
PART III GENERAL HEALTH
Does your child have any food allergies orsensitivities?
Does your child have dietary restrictions?
PART IV: Educational and Therapeutic information
Therapeutic Activities/Interventions (Check all that apply):
Is your child currently enrolled in a school?
Has your child every repeated a grade?
PART V: Child and Family Strength and Goals
THANK YOU!
To complete the application in full please submit the following documents to Illuminate Academy. You can mail or hand deliver documents to: Illuminate academy 1033 Burchwood ave. Nashville, Tn 37216
Please send the following assesments and evaluations (if applicable)
Psycho-educational behavioral/ aba evaluation ot evaluation slp evaluation pt evaluation gifted testing or educational tutoring evaluation developmental vision or hearing evaluation any relevant evaluations
Additionally please send:
most recent progress report most recent 504/iep/ifsp plan current writing sample (within past 3 months) name of most recent book (read independently or with assitance) application fee of $175 (check payable to illuminate academy)