Are you a returning ARC Academy student?

Yes

No

Student Information:

Please complete this section accurately as it is directly reflected in Jupiter, ARCA's SIS.

Student's first name:

Student's middle name:

Student's last name:

Student's preferred name:

Student's gender:

He

She

Date of Birth:

Month

Day

Year

Student's Race/Ethnicity: Please choose all that apply.

Student's Incoming Grade Level: Please choose one.

Student's mailing address: Address only.

City of mailing address: City only.

State of mailing address: State only.

Zip Code of mailing address: Zip code only.

Student's email address:

Student's phone number: Please include the area code.

Student's last school attended:

Primary Contact Information:

The primary contact is the individual that will primarily receieve billing, communication, grade reports, attendance, etc.

Primary Contacts Relation to Student:

Primary Contact first and last name:

Primary Contact email address:

Primary Contact phone number: Please include area code.

Primary Contact employer and phone number: Please include area code.

Secondary Contact:

The Secondary Contact is the individual that will receive billing, communication, grade reports, attendance, etc. in the event that the Primary Contact can not be reached.

Secondary Contact Relation to Student:

Secondary Contact first and last name:

Secondary Contact email address:

Secondary Contact phone number: Please include area code.

Secondary Contact employer and phone number: Please include area code.

Student Academic & Behavioral Information:

Has the student failed or been retained? If so, what grade was repeated?

Does student have an I.E.P. (Individualized Education Program) issued from previous school?

Does the student have a current 504 plan or any other plan recommending accommodations?

Is the student in good standing and eligible to re-enter current school at the next level? If not, please explain why.

Has the student ever been disciplined, by any other school, for the use of drugs, alcohol, or tobacco (including vapes)? If so, provide details of the disciplinary action.

Has the student ever been disciplined, by any other school, for promiscuous, violent, or inappropriate behavior? If so, provide details of the disciplinary action.

Has the student ever been suspended or expelled from any other school? If so, provide details of the event(s).

Alternate Emergency Contact:

The alternate emergency contact is contacted in the event that neither the primary nor the secondary contact are available. Please list three or less. If no one else is needed for alternate emergency contact: please skip this section. *Primary contacts can edit this list at anytime via Jupiter.

#1 Alternate Emergency Contact Relation to Student:

#1 Alternate Emergency Contact first and last name:

#1 Alternate Emergency Contact phone number: Please include area code.

#2 Alternate Emergency Contact Relation to Student:

#2 Alternate Emergency Contact first and last name:

#2 Alternate Emergency Contact phone number: Please include area code.

#3 Alternate Emergency Contact Relation to Student:

#3 Alternate Emergency Contact first and last name:

#3 Alternate Emergency Contact phone number: Please include area code.

Authorized Pick-Up:

Please complete this section for anyone who is authorized to pick up your student from school but is not primary, secondary, or alternate contact. Please list three or less. If no one else is needed for authorized pick-up: please skip this section. *Primary contacts can edit this list at anytime via Jupiter.

#1 Authorized pick-up first and last name:

#1 Authorized pick-up phone number: Please include area code.

#2 Authorized pick-up first and last name:

#2 Authorized pick-up phone number: Please include area code.

#3 Authorized pick-up first and last name:

#3 Authorized pick-up phone number: Please include area code.

Student Health Information:

Please provide the health care related information requested below. Be assured that all information in this section will be held as personal and private and is able to be viewed by ARCA administration only. Depending on the nature of the need, generic information may be shared with staff, such as: student's homeroom teacher and P.E. teacher on an as needed basis.

Student's Primary Health Care Provider:

Student's Primary Health Clinic:

Student's Primary Health Clinic phone number: Please include area code.

Are there any special needs, allergies, mobility, or health related issues that we need to be aware of? If so, please list below.

Are there any medications that need to administered to your student while in our care? If so, please list medication(s), time of administration, and amount to be taken below. *Please note that a Dr. note or prescription may be required.

Before and After School Care:

Before and after school care is optional for a fee. Before schoole care is prior to 7:15 am. Arrangements for before school care must be made through ARCA administration. For more information contact Kevin Stewart via email: stewart@arcacademywm.net After school care is beyond 3:45 pm. After school care must be scheduled through The Little ARC Academy. Contact Penny Chilton (318-537-9104) for more information.

Does your student need regular before school care before 7:15 a.m.?

Yes

No

Does your student need regular after school care beyond 3:45 p.m.?

Yes

No

Competitive Athletics

Does the student intend to participate in competitive sports during the '26-'27 school year? If yes, please choose the sport(s) of interest. (multiple sports can be chosen)

General Information and Agreement to Obligations:

Please read this section and associated links carefully as they will outline the agreements necessary for your student to attend ARC Academy.

Special Needs Education Policy:

I understand

Special Needs Education Policy

Admission Policy:

I understand

Admission Policy

Tuition:

I have read the information below and agree to these terms.

Tuition is set up on a ten-month payment plan for your convenience. The first payment is due August 1. Tuition must be paid monthly and is due on the first of each month. Any tuition not received by the 10th of the month due will be subject to a monthly service fee of $50.00. Payment of late fees does not postpone the due date of any tuition. We do not prorate tuition for any reason. All payments due must be current before households will be allowed to enroll in the following school year.

Tuition, Enrollment, and Curriculum Fees:

I agree

I have read the Tuition, Enrollment, and Curriculum Fee information for the ARCA 2026-2027 school year and agree to uphold my commitment to these financial obligations. Click the link below for more details.

ARC Academy Tuition and Fees 2026-2027

Student Expectations and the ARCA Student Handbook:

I agree to the below

ARCA students are required to adhere to the expectations outlined in the ARCA Student Handbook at all times. Infractions to student expectations will result in disciplinary action as defined in the handbook. Please click the link below to view the ARCA Student Handbook.

ARC Academy Handbook

Disciplinary Policy:

I agree to the policy below

I hereby grant the teachers and administration full authority to discipline my student according to the expectations outlined in the ARCA Student handbook. This may include various forms of positive reinforcement, the issuing of detention, in-school suspension, suspension, or expulsion from the school.

Health and Wellbeing Policy

I agree to the policy below

Health and Wellbeing Policy

Technology and Personal Device Policy:

I agree to policy below

Technology and Personal Device Policy

School Activities and Media Permission:

I agree to the below

I disagree to the below

I give my permission for my student to participate in all school activities and school sponsored trips. I authorize ARCA to take photographs and/or videos of school activities and post them for promotional purposes benefiting the school.

Athletics and Extra Curricular Activities Policy

I agree to the policy below

Athletics and Extra Curricular Activites

School Closure/Delay:

I agree to the below

In the event of inclement weather/emergency conditions, ARCA administration will monitor Ouachita Parish School cancellations. Ouachita Parish school closure or delay may or may not result in ARCA closure or delay. Factors, such as, student/staff safety, productivity, etc. will be considered before delay or cancellation of school. Notice of delay/closure will be communicated as soon as possible. School closures will be communicated via the school calendar.

Legal Liability Agreement

I agree to agreement below

Legal Liability Agreement

Statement of Cooperation:

I agree to the statement below

Statement of Cooperation

NOTE:

I agree to the below

This application is for the express purpose of reserving your student's enrollment at ARC Academy. Students are conditionally enrolled after this application has been processed and approved by ARCA administration. Students are not formally enrolled until financial obligations, such as, enrollment fee, first month's tuition, and first month's curriculum fee have been collected and processed, as well as, the receipt of all required documentation.

Signature

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Questions and Feedback:

Thank you for completing this form. Please take a moment and review for accuracy as the imformation provided by this form directly impacts your student's information in Jupiter. Please feel free to ask any clarifying questions or offer any feedback below. Thank you for trusting ARCA with your student's academic needs.

Questions and Feedback

Enrollment Fee: $75

$

*Please add 3% to cover processing fee(s).

**Disclaimer: The enrollment fee is charged per household. If you have already paid an enrollment fee for another student in your household, please do not submit an additional payment.