WELCOME TO DOVE ACADEMY OF DETROIT 2008-2009

8210 ROLYAT - DETROIT, MI  48234   -  (313) 366-9110 - OFFICE /(313) 366-9130 - FAX

APPLICATIONS MUST HAVE COPIES OF BIRTH CERTIFICATE, AND IMMUNIZATION RECORD Kindergarten must have original birth certificate ATTACHED

(1^ST - 6^TH GRADES PLEASE INCLUDE COPY OF LAST REPORT CARD.)

Grades K-6

Today’s Date: _____/________/______

Child’s Name: __________________________________________________________________________   

                              Last     (please print all information on this form)                                  First                                       MI                       

 Male  ?        Female  ?

Address: _____________________________________________________________________________

                    Street                                                 City                                                State                            Zip

Phone: (         )_______________________     Birthdate: _______/_______/______     Current Age:________

Mother or Guardian:  ____________________________________________________________________

Address: _____________________________________________________________________________