Admissions Application

Oak Ridge Military Academy Application

This application is for new students only.

Requested Start Date*

Applicant to enter grade*

Boarding Status*

Gender

Male
Female

Name*

First Last

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Citizenship*

Date of Birth*

Father's Information

Name*

First Last

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone Number*

Email Address*

Mother's Information

Mother's Name*

First Last

Address (if different from above)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone Number*

Email*

Are the applicant's parents separated or divorced?*

Yes
No

If yes, who has legal custody?*

Father
Mother
Joint

Who will be financially responsible?*

Father
Mother

Emergency Contact Data (Other than parent)

Name*

First Last

Relationship*

Phone Number*

Medical Data

Please list medical conditions, disabilities, or allergies:

Is the applicant required to take any medication?*

Yes
No

Please specify

Guidance Data

Current School*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone Number*

Dates of Attendance*

Grade(s) Completed*

Additional Information

Does the applicant have an Individualized Education Plan?*

Yes
No

Has the applicant skipped or repeated a grade?*

Yes
No

Has the applicant been identified as having a learning difference or disability?*

Yes
No

Has the applicant been identified as having ADD/ADHD?*

Yes
No

Has the applicant been identified as having ODD/OCD or being Bipolar?*

Yes
No

Has the applicant ever undergone an educational evaluation administered by a clinical psychologist, psychiatrist, or counselor?*

Yes
No

If your child has been identified as having ODD, OCD or being Bipolar, you must provide a psychological evaluation prior to an acceptance decision.

Has the applicant ever been dismissed/expelled from school?*

Yes
No

Has the applicant ever had an out-of-school suspension?*

Yes
No

Has the applicant ever been involved in physical violence?*

Yes
No

Has the applicant ever experimented with alcohol or drugs?*

Yes
No

Has the applicant ever been treated for substance abuse (alcohol/drugs)?*

Yes
No

Has the applicant ever been convicted of a crime or is currently awaiting trial?*

Yes
No

Has the applicant ever been or is he/she currently on probation?*

Yes
No

If yes to any of the previous questions, please explain:

ORMA Admissions Policy Regarding Chronic Health Conditions When an applicant to ORMA has a chronic health condition, ORMA staff will request medical information directly from the student's primary care physician and other healthcare provider(s) prescribing medication or providing other healthcare services to the student. Staff will review this information with ORMA medical consultant(s), who may contact the parents and physician(s) to discuss the student's needs in more depth. The consultant(s) may charge the parent for this consultation. With guidance of the consultant(s), ORMA will determine whether and how ORMA can meet the student's healthcare needs. Failure of parents to disclose health information to ORMA prior to the student's admission may result in suspension of the student without refund of fees.

Has the student ever been under treatment for any medical/behavioral/emotional or learning problem?*

Yes
No

If yes, please explain:

Please list any health professional who has provided service to your student in the past year:

Special Interests and Activities Data

Has the applicant participated in a JROTC/military program?*

Yes
No

What rank do they hold?

List any special awards or accomplishments, any sports/extra-curricular activities and/or community service projects in which the applicant has participated

How did you first learn about Oak Ridge Military Academy?*

Please Specify

Please tell us the name of the Cadet who referred you:

Please tell us the name of the Parent who referred you:

Please tell us the name of the Educational Consultant who referred you:

Certification

I certify that the information on this application for admission is correct to the best of my knowledge, and I agree to immediately notify ORMA in writing when any changes to the above information occur. I understand any deliberate falsification or misrepresentation on this student application or other information provided to the Academy may result in dismissal. I understand the Academy is unable to personalize, customize, or individualize the academic curriculum or behavioral standards for young people with special needs. I further understand I am entering into a one year contract with the Academy, and if my child is withdrawn or dismissed I am not entitled to a refund.

*

I agree to these terms above

Date

Oak Ridge Military Academy admits students of any race, color, religion, national and ethnic orgins. It does not discriminate on the basis of race, color, religion, national or ethnic origin in the administration of its admissions policies.

$50 Non-Refundable Application Fee must be Submitted with this completed form.

Application Fee (includes a 2.75% application fee)

Price: $51.38

*

I agree to the charge of $51.38 to be made to my credit card.

Credit Card*

American Express

Discover

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

Billing Address*

Street Address Address Line 2 City State ZIP Code

Primary Email Address*

NOTE: This entire form must be complete. After you press the submit button below, scroll back up to the top of the page to see if you need to correct any errors.

OAK RIDGE MILITARY ACADEMYest 1852

OAK RIDGE MILITARY ACADEMYest 1852