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admissions@treca.org
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Application for Admission

Please Note: All information remains confidential.Much of this information is required by the Ohio Department of Education and is used for statistical purposes. This application should be complete. Thank you for you cooperation.

What will be required after completing the online application?

Would you prefer to mail a paper application, instead? You can print one here.

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NOTE: * denotes required fields

Part I: Student Information

First Name*
 Last Name*
Middle Name
 Call Name
Append (Jr., III, etc.)
 Gender*
Address*
 Apt., Lot, or P.O. Box
City*
 State and Zip
County of Residence*
 Home Phone
( )
Cell Phone
( )
Contact Email*
 Mother's Maiden Name
Date of Birth(mm/dd/yyyy)*
 Birth City and State
Ever attended online school before?
YesNo
 If yes, name of online school
Are you currently attending school?
YesNo
Is currently home-schooled?
YesNo
Name of last school attended
 Reason for leaving
Last attended date(mm/dd/yyyy)
 Last Grade Completed
Current Grade*
 School Year Applying for
2009-20102010-2011
Ethnicity*
Native Language

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Part II: Parent/Guardian Information

Applicant lives with mother
YesNo
 Applicant lives with father
YesNo

If applicant does not live with either parent, then please use the Comments field to provide contact information for the legal guardian instead. Include address, if different than the applicant's address.
Mother's Information
Mother's First Name
 Mother's Last Name
Mother's Address
Mother's City
 Mother's State and Zip
Mother's Work Phone
()ext.
Father's Information
Father's First Name
 Father's Last Name
Father's Address
Father's City
 Father's State and Zip
Father's Work Phone
()ext.
Contact Mailing Address (if different from applicant)
Contact Mailing Address
 Contact Apt., Lot, or P.O. Box
Contact Mailing City
 Contact Mailing State and Zip
Comments/Additional Information(Optional)
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Part III: Special Needs Information

Does applicant have special educational needs?
YesNo
 If yes, the school will contact you promptly so that all appropriate arrangements can be made.

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Part IV: Additional Information

TDA will provide an Internet Service Provider for a home phone line. You may at your cost use another internet provider
How did you learn about us?*
If other, please specify
Shoe Size (Nike recommends a half size larger than your regular street shoe size. Nike+ shoes will be issued to all full-time students as part of the Health and Wellness program.)
Approximate schedule this semester (Optional. All schedules require Guidance Office approval.)

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