Victory Life Academy

Referral Form

Date______________________

Name of family giving referral_____________________________________________

Name of family referred _________________________________________________

Child Name_________________________________________________

Child Name_________________________________________________

Child Name_________________________________________________

Child Name_________________________________________________

To the family enrolling your child/ren in Victory Life Academy, by signing this form, you are acknowledging that you were informed and encouraged to enroll your children in this Academy by the family named above. The family named above will receive a $250 credit off of their tuition after you have enrolled and paid 2 months of your own tuition. The above family will receive only a $250 credit per family, not per child. If you have any questions, please call the school office. Thank you.

_________________________________________________________________ _____________________

Signature of Parent/s enrolling children in Victory Life Academy Date