STUDENT APPLICATION
GREENVILLE CHRISTIAN ACADEMY
1621 GREENVILLE BOULEVARD, SW
GREENVILLE,NC . 27834-7027
SCHOOL PHONE: 252.756.0939
APPLICATION FOR STUDENT ADMISSION (To
Be Completed By Parent) Fill out the form below, then print.
OFFICE USE
ONLY
Application Rec'd
Interview
Entrance Test
Acceptance Date
School
Year 20
-20
Last Grade Completed
Or Present Grade
Grade Applying for
Please
attach a
recent photo
STUDENT INFORMATION
Name
Social
Security #
Home
Tel.
Address
City
Zip
Place
of Birth
Age
Sex
Birth
date
Name and Complete
Address of Last School Attended
Person (other
than parents) to contact in emergency and can pick up child
at anytime:
Does child
live with both parents?
If not indicate
with whom:
Other children
in this family:
Names
School
Age
Grandparents'
Name
Address
City
State
Zip
Grandparents'
Name
Address
City
State
Zip
CHURCH AFFILIATION
Church Attending
Pastor
Address
City
State
Zip
Father: Christian? Yes
No
If yes, briefly state your salvation
experience:
Mother: Christian? Yes
No
If yes, briefly state your salvation
experience:
Has the Applicant ever
made a profession of faith in Christ? Yes
No
MEDICAL INFORMATION
Family Physician
Phone
Address
City
State
Zip
Family Dentist
Phone
Address
City
State
Zip
Does child have any physical challenges or allergies?
Does child have State
required immunizations and can you provide the school with records
to verify this (only Kindergarten or out of state applicants)?
SCHOLASTIC INFORMATION
Has child
ever been expelled, dismissed, suspended, or refused admission to
another school?
Explain:
Has child ever had any disciplinary difficulties?
If yes, detail:
Has child ever been in trouble with the law, arrested, etc.?
Explain:
Has child ever used tobacco or drugs of any kind?
Explain:
Please indicate academic
level of pupil's previous work: Excellent
Good
Average
Poor
(*Please
enclose the applicant's last report card or copy.)
Has child ever been moved ahead or held back a grade in school?
Explain:
GENERAL INFORMATION
How did you hear about this school?
Reason for selecting Greenville Christian Academy?
STANDARD OF CONDUCT
This
section must be read and completed by all applicants applying
for grades 7 through 12. Others may disregard.
The student's
attitudes, conversation, and behavior reflect the character of
the institution from which he derives his training, both home and
school. This section of the application reflects Greenville Christian
Academy's attempts to secure students who would best adjust to
the rigor of a disciplined training program which must set high
standards to maintain academic and spiritual integrity.
Do you attend
church regularly?
Where?
Are you a Christian?
If yes, please describe your salvation experience on a separate
piece of paper and attach it to this application.
At what age
were you saved?
Do you accept
the Bible as God's Word and submit yourself to its principles as
a final authority?
Will you agree
to honestly and in good spirit maintain the school dress code?
Will you honestly
agree to keep all school rules and respect authority without being
critical or finding fault?
Will you submit
to the authority of the teacher in the classroom in all situations?
Do you agree
to do all outside classwork required?
Do you WANT to attend Greenville
Christian Academy?
Why?
GENERAL POLICY:
Students
are expected to abide by these standards of conduct throughout
their enrollment whether at home, school or elsewhere. Students
found to be out of harmony with Greenville Christian Academy's
ideals of work and life may be invited to withdraw whenever the
administration determines that it is necessary.
As a student of
Greenville Christian Academy, I pledge to uphold the school's standards
against cheating, swearing, smoking, drinking alcoholic beverages,
using or talking favorably about narcotics, or using indecent language
and will act in a very orderly and respectful manner. I will maintain
Christian standards in courtesy, kindness, morality and honesty.
I will strive to be of unquestionable character in dress, conduct,
and other areas of life.
I agree to abide by the above standards
of conduct and other regulations expected of each student enrolled
in Greenville Christian Academy while I am a student attending
the school. and will not give the impression to students, parents,
or faculty that I am in disagreement with the goals, aims, and
standards of this Christian school.
Date
Student's
Signature
Principal's
Signature
STATEMENT OF COOPERATION
In making application
for my child, it is my desire to have him/her receive quality training
in a good Christian atmosphere. In addition, I realize that attendance
at Greenville Christian Academy is a privilege and not a right.
Whenever I or my child refuse to cooperate with the spirit of the
school or its rules, I realize that I will be asked to withdraw
my child.
I give Greenville Christian Academy permission for my
child to take part in all school activities, including bus trips,
sports activities, and school-sponsored trips away from school
premises. Moreover, I absolve Greenville Christian Academy of any
liability to me or my child because of any injury at school or
during any school activity.
Should any legal action, for any reason,
be taken against Greenville Christian Academy or any employee or
agent thereof, on my child’s
behalf and the school or its agent not be found at fault, I agree
to pay any attorney fees, court fees, damages or other costs that
Greenville Christian Academy or its agent should incur to defend
itself against such action.
I also believe that discipline is necessary
for the welfare of each student, as well as for the entire school.
I give permission for my child’s teacher and/or agent of
the school to make and enforce classroom regulations in a manner
consistent with Christian principles and discipline as set forth
in the Scriptures.
I understand, in the elementary grades, after
all other means of discipline have been exhausted, including parent
contact, that corporal punishment may be used as a means of discipline.
I understand the registration fee is not refundable unless the
school initiates withdrawal. I have read the financial policies
and agree to pay my tuition on time.
I understand that the school
cannot educate my child alone: and therefore, it is my desire to
attend all P.T.F. functions and other events that would support
the school in the education of my child.
I HAVE READ THE STATEMENT
OF COOPERATION AND WILL ABIDE WITH THE POLICIES SET FORTH.
Husband's
Signature
Wife's Signature
Date
Please indicate
below how you want your account set up for payment and mailing
information:
