The Haven Academy Online Registration

Registration

Welcome to Canton Homeschool Resources and The Haven Academy! Please complete the following forms. All registrations are subject to approval and availability. Social security number is only required for 8th-12 grade students to be entered into Ga Futures. Other students may type 111-11-1111 PLEASE be sure you are registering for classes that start with 2022-2023 if you are registering for fall. You can search by 2022-2023 if you do not want to scroll through them all.

* denotes required fields

Referral Information

How did you hear about us?

Referral Name

Family Information

Family Last Name*

Where do you live?

Home Address*

City*

State*

Zip*

Home or Primary Phone*

Additional Info

Emergency Contact Info (Not Contact #1 or #2)

Contact #1

Contact #1 First Name*

Last Name *

Type*

How Can We Contact You?

Home Phone

Work #

Cell # *

Email* (Emails are kept confidential)

Confirm Email*

Contact #2

Contact #2 First Name*

Last Name*

Type*

How can we contact you?

Home Phone

Work #

Cell # *

Email (Emails are kept confidential)

Confirm Email

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Immunization Notes

Previous School*

Social Security # *

Grade level entering *

When you click the button below, all of our options pop up. Use the magnifying glass search feature tonarrow your choices by grade, summer or fall, online/in person, etc.

Enroll in Classes

Select Class *

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Immunization Notes

Previous School*

Social Security # *

Grade level entering *

When you click the button below, all of our options pop up. Use the magnifying glass search feature tonarrow your choices by grade, summer or fall, online/in person, etc.

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Immunization Notes

Previous School*

Social Security # *

Grade level entering *

When you click the button below, all of our options pop up. Use the magnifying glass search feature tonarrow your choices by grade, summer or fall, online/in person, etc.

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Immunization Notes

Previous School*

Social Security # *

Grade level entering *

When you click the button below, all of our options pop up. Use the magnifying glass search feature tonarrow your choices by grade, summer or fall, online/in person, etc.

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Immunization Notes

Previous School*

Social Security # *

Grade level entering *

When you click the button below, all of our options pop up. Use the magnifying glass search feature tonarrow your choices by grade, summer or fall, online/in person, etc.

Enroll in Classes

Select Class

Add Another Student

Required Policies

(Show-Hide Details)

Questions or Concerns

Comments

Registration

Referral Information

Family Information

Where do you live?

Additional Info

Contact #1

How Can We Contact You?

Contact #2

How can we contact you?

Student #1

Additional Info

Enroll in Classes

Student #2 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #3 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #4 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #5 (Show-Hide Details)

Additional Info

Enroll in Classes

Required Policies (Show-Hide Details)

I Agree to All of the Above

Questions or Concerns

Required Policies

(Show-Hide Details)