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DAA student application*

Student Contact Information

First Name

Last Name

Preferred Name

Who is your contact that shared information about DAA?

If other, please provide a name.

Date of Birth

Gender

Grade Entering

Student Citizenship

Address

City

State/Province

Zip/Postal

Country

Primary Phone

Why I want to attend DAA

0 of 500 max characters

Parent #1 Contact Information

First Name

Last Name

Address

City

State/Province

Zip/Postal

Country

Primary Phone

Parent #2 Contact Information

First Name

Last Name

Address

City

State/Province

Zip/Postal

Country

Primary Phone

Medical Information

Are there any medical conditions that might affect your life at school?

If yes please explain

Education Information

8th Grade School

School's Phone

School's Email

Report Card Submitted?

Upload Recommendations & Transcripts

Maximum file size: 15MB

List most recent highschool attended and years of attendance.

Highest Grade Completed

Residence Information

Please check all that apply:

Dorm Student

Day Student

Reference 1

Principal/Teacher Name

Last Name

Phone

Reference 2

Pastor/Coach Name

Last Name

Primary Phone

Reference 3

Adult (non-family) Name

Last Name

Primary Phone

Submit Application Fee after you submit this form.

Application Fee: $100.00

Disclaimer: We will contact you/your parents prior to processing your application

By submitting this application you are agreeing to abide by all school rules and to follow the Handbook upon acceptance into Dakota Adventist Academy.

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