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SECOND
BAPTIST CHRISTIAN ACADEMY |
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STUDENT APPLICATION 2009-2010
Date of Application: _______________________________
SECTION I - ABOUT THE STUDENT
Student will be in grade: Infant Early Toddler K2 K3 K4 K5 1 2 3 4 5 (circle one)
Student Name: ________________________________________________________________________________
Last First Middle
Birth Date: ____________________ Sex: _____ Race: __________________ SSN: ________________________
Residence address: _____________________________________________________________________________
Mailing address (if different): ______________________________________________________________________
Home phone: _____________________________ Work phone (if employed): ______________________________
Present/last school attended: ______________________________________________________________________
Name City
School Principal’s Name: ________________________________________ Last grade completed: _____________
SECTION II - ABOUT THE STUDENT’S FAMILY
Student’s Father: ______________________________________________________________________________
Name Address Phone
Father’s Employment: __________________________________________________________________________
Company Job
Title Phone
Student’s Mother: _____________________________________________________________________________
Name Address Phone
Mother’s Employment: _________________________________________________________________________
Company Job
Title Phone
Student lives with: ___ BOTH PARENTS ___ FATHER ___ MOTHER ___ OTHER LEGAL GUARDIAN*
*Student’s Guardian: ___________________________________________________________________________
Name Address Phone
*Guardian’s Employment: ______________________________________________________________________
Company Job Title Phone
Other children under age 18 in the student’s home (list name, age, and school): ____________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
Second Baptist Student Application, page 2
Is the student… a professing Christian? _____ active in a local church? _____
Is the student’s father… a professing Christian? _____ active in a local church? _____
Is the student’s mother… a professing Christian? _____ active in a local church? _____
Is the student’s guardian… a professing Christian? _____ active in a local church? _____
EMERGENCY CONTACT: responsible adult to call if parents/guardian cannot be reached:
____________________________________________________________________________________________
Name Relationship Home Phone Work Phone
Has this person already agreed to be your emergency contact? _______
Is this person authorized to pick your student up from school? _______
SECTION III - MORE ABOUT THE STUDENT
List any subject (s) in which the student has excelled, or school honors achieved: ______________________________
____________________________________________________________________________________________
List any subject (s) in which the student is not working at grade level or above: _______________________________
____________________________________________________________________________________________
If the student has any diagnosed learning disabilities, please identify, list symptoms, and explain how the condition (s) is
being treated:
____________________________________________________________________________________________
____________________________________________________________________________________________
If the student has any mental, emotional, or physical hardship that might affect school participation, explain here:
____________________________________________________________________________________________
____________________________________________________________________________________________
If the student been subjected to corporal punishment, suspension, or expulsion at any previous school, explain here:
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
If the student has any type of criminal record, or is under any judicial/law enforcement supervision, explain here:
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
Briefly describe the student’s attitude and response toward parental, school, and/or legal authority and discipline:
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
Second Baptist Student Application, page 3
Briefly describe the student’s personality, relationship to parents and siblings, and general attitude toward school:
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
How will the student be transported to school each morning? _____________________________________________
How will the student be transported from school each afternoon? __________________________________________
If the student will be operating a motor vehicle on school property, please supply the following information:
_____________________________________________ _____________________________________________
Auto color, make and model License plate number Student’s Driver’s License number Expiration date
(Purchase of a SBCA parking decal will be
required.)
*********
PLEASE HAVE THE STUDENT COMPLETE THE FOLLOWING
SECTION
*********
SECTION
IV - FROM THE STUDENT
Please describe your hobbies and interests. What are the things you enjoy doing the most?
____________________________________________________________________________________________
____________________________________________________________________________________________
Please tell us the things you like most about school… and the things you like least… and WHY.
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
Why are you interested in attending a Christian school in general, and Faith High in particular?
____________________________________________________________________________________________
____________________________________________________________________________________________
What are the accomplishments you are most proud of in your life to this point? _______________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
What do you hope to achieve in your life? What are your goals and ambitions for the future?
____________________________________________________________________________________________
____________________________________________________________________________________________
Who are your two favorite Bible characters, and why? __________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
Which statement best describes you? ___ Not really interested in spiritual things. ___ Not a Christian yet.
___ Not sure if I am a Christian. ___ Need to be a better Christian. ___ Jesus Christ is Lord of my life.
