Online Application Grades 7-12

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1 Online Application Grades 7-12 Full Time Missionary Family? Yes No If yes, are you associated with Shadow Mountain? Yes No Student Information (To be completed by parent or guardian. Please print legibly.) Applicant s Name: Student: Last First Middle Grade Entering: Date of Birth Home State/Country Student Address Gender: M F Ethnicity (Optional): American Indian/Alaskan Native Asian White African American Hispanic Native American/Pacific Islander Other Names, ages, and grades of other children in the family (Circle any who have attended or are currently attending Christian Unified either online or on campus.) Family Information (Please completely answer all questions) Father: Name Marital Status Address City State Zip Address Home Phone Cell Phone Occupation: Title Name of Company Business Telephone Mother Name Marital Status Address: If different from Father City State Zip Address Home Phone Cell Phone Occupation: Title Name of Company Business Telephone

2 If someone other than the parents will be overseeing this student s online education (coach, tutor, grandparents, etc.) please provide the contact information for this person. We also require a parent s signature to authorize this person having access to school records and being included in correspondence concerning the student s academic progress. They will not be allowed to make any financial decisions unless previously authorized by the parent/guardian of the student. Name Relationship Address City State Zip Address Home Phone Cell Phone Parent Signature: Date Information About the Applicant Must be completed for application to be considered. Present School Grade Telephone School Address City State Zip School year for which admittance is being sought What church does the family attend? Please explain why you wish for your child to attend Christian Unified Schools. How did you hear about Christian Unified Schools? Please provide names where possible. Alumnus Pastor Sports Current Student Open House Mailings Faculty Member Web Site Other Social Media Television/Radio CUSSD admits students of any race, color, national, and ethnic origin to all the rights and privileges, programs, and activities generally accorded, or made available, to students at the school. We do not discriminate on the basis of race, color, national, and ethnic origin in administration of our educational policies, admissions policies, athletic, and other school administered programs, nor in the hiring of faculty or administration.

3 Required STUDENT RECORDS Please provide the following records so that we have adequate information to review your application and recommend classes. Please include the following school records with your application Transcript with explanation of grading system, noting any advanced courses. Last two years of report cards if the student is entering 7th through 9th grade Discipline records. If you have been a homeschool family, include any discipline issues in the Parent Questionnaire section Parent Signature Date Please return the completed application and required documents to: Kathleen Alesi Online Coordinator Christian Jr/Sr High School kalesi@christianunified.org

4 Family Statement of Faith The Statement of Faith does not exhaust the extent of our beliefs. The Bible itself, as the inspired, inerrant, plenary, and infallible Word of God that speaks with final authority concerning truth, morality, and the proper conduct of mankind, is the sole and final source of all that we believe. For purposes of CUSSD s faith, doctrine, practice, policy, and discipline, Shadow Mountain Community Church is CUSSD s final interpretive authority on the Bible s meaning and application. We believe that there is one God eternally existent in three persons: Father, Son and Holy Spirit. We believe in the deity of our Lord Jesus Christ, in His virgin birth, and His sinless life, in His miracles, in His vicarious and atoning death through the shedding of His blood, in His bodily resurrection on the third day, in His ascension to the right hand of the Father, and In His personal pre-millennial return to rapture His Church before the Tribulation and His glorious appearing to set up His Millennial Kingdom. We believe that salvation is by grace alone through faith, apart from works by the merit of the shed blood of Christ, and that the born-again believer is eternally secure in Christ. We believe in the present ministry of the Holy Spirit by whose indwelling the Christian is enabled to live a godly life. We believe in the resurrection of both the saved and the lost; they that are saved unto the resurrection of life, and they that are lost unto the resurrection of damnation. We believe in the spiritual unity of believers in our Lord Jesus Christ. We believe in the individual priesthood of the believer. We believe life begins at conception. We believe that the term marriage has only one meaning; the uniting of one biological man and one biological woman in a single, exclusive union, as delineated in Scripture. (Gen. 2:18-25.) We believe that God intends sexual intimacy to occur only between a biological man and a biological woman who are married to each other. (1 Cor. 6:18; 7:2-5; Heb. 13:4.) We believe that God has commanded that no intimate sexual activity be engaged in outside of a marriage between a man and a woman. We believe that the Scripture dictates standards of sexual behavior. The unique roles of the male and female are clearly defined in Scripture. Any promiscuity, homosexuality, gender identity issues or other deviations from Biblical principles is a sin that is offensive to God (Matt. 5:18-19; I Cor. 6: 9-10, 19-20; Eph. 5:3-5; 1 Thess. 4:3-8).

5 I/We agree to the following financial policies: An APPLICATION FEE of $ per student is due at the time of application for new students. Application fees are non-refundable. A $50.00 Reenrollment fee is due before registration for the next term. Reenrollment fees are non-refundable after the first day of class. THE ANNUAL TUITION is payable in full prior to enrollment. WITHDRAWAL A course withdrawal is required when a family decides to withdraw their student from a course prior to the original selected course end date. Transcript Considerations: Students who withdraw during the first 28 days will not receive a transcript. Students who withdraw after 28 calendar days will receive either a WP (withdraw passing) or WF (withdraw failing) on their transcript depending on their grade at the time of withdrawal. Course Withdrawal Request timing and refund policy: Requests made before Course Start Date: o Enrollment Change Requests: No fee to change courses. o Course Withdrawal Requests: Full refund of course tuition paid. Application or Reenrollment fees are non-refundable Course Withdrawal Requests made on or after Course Start Date: o Course Start Date-10 calendar days from the course start date: Refund of course tuition paid (per course) minus a $200 fee. o calendar days from the course start date: Refund of course tuition paid (per course) minus a $400 fee. o calendar days from the course start date: Refund of course tuition paid (per course) minus a $500 fee. o calendar days from the course start date: Refund of course tuition paid (per course) minus a $600 fee. o 60+ calendar days from the course start date: No credits or refunds. RETURNED CHECKS Returned checks are charged a $35.00 fee and require replacement in the form of a money order or cash. If the check is not made good within 5 days, enrollments will be canceled. ACADEMIC PROBATION For students using the CUSSD online program for remediating a failing grade, or for students who are administratively approved to complete a semester or a year online while on suspension, the following academic policy will apply: The student must be on track with assignments current, and a passing grade of C at 25 days in the course. If these conditions are not met, the student will have an additional 15 days to catch up their assignments/remediate the grade, or it will be recommended at 40 days that the student not continue in the program. The refund policies will be strictly enforced. It may be additionally required that the

6 parents enroll these students for only one semester until the student s ability to learn online is verified. COURSE PAUSE/DELAY A course pause/delay may be requested when a family decides a student needs a stoppage of work in a course with plans for the student to re-start the course at a later date. Students are only eligible for a course pause/delay request when they are making good progress in the course. Example situations where this option should be considered: Health issues; Family crisis. The student must complete the course within 6 months of the current semester start date per semester. A course delay fee of $75.00 per course must be paid no matter when the delay is requested (1+ days after the start date of the course) COURSE EXTENSION POLICY If a student needs to go beyond the original enrollment end date in order to successfully complete a course, the person who enrolled the student can file for an extension. Students must have successfully completed 50 percent of the course work prior to requesting an extension and may request up to an additional 4 weeks for a one semester course or 8 weeks for a two-semester (full year) course. Only one extension per course will be considered. Students must be working consistently in the course at the time of the extension request. The maximum time in a course is as follows: 6 months for a 1-semester course 12 months for 2-semester course The extension request should not exceed those parameters. The course extension form should be filled out at least 2 weeks prior to the current end date of the student's course, which is listed in the Student Information System. If the student does not complete the course requirements by the end of the extension, he/she will receive a final grade for the course based both on the work completed as well as 0 s which have been submitted for undone work Course Extension Fees: If the request for a class extension is placed at least two weeks before the student s end date in the course and does not exceed the maximum time period in a course, there will be a $40 fee per course. If the request is approved, the dates in the course will automatically adjust to the new end date and the new target dates must be strictly adhered to. The target dates are meant to help the student stay on track toward success. I have read and understand the above Financial Policies Parent Signature Date

7 Student Name Grade ONLINE COURSE CONTRACT ACADEMIC POLICIES I agree: To set aside at least hours per course per week to go through the course materials and complete all the required assignments. Actual time required may vary from course to course or assignment to assignment. To communicate frequently with the course instructor. Communication is highly encouraged via and Skype (a voice-over-ip technology requiring an internet connection and a Skype account). Traditional phone calls may also be necessary and may incur long-distance charges. These fees are not covered in the cost of the course. This course may not be dropped and must be completed once started. Extensions may be given for special circumstances, but additional fees may be assessed. (See the Financial Policies Page) I agree to abide by the policies of Sevenstar as outlined on their website: ( Please know that even though Sevenstar and Christian High School are partners in Christian education, we are separate entities and have different class policies. Any questions regarding class policies may be directed through the CHS Coordinator, but Sevenstar is the final authority on these matters. That Christian High School enrollment policies are still applicable to the online course, in addition to Sevenstar s policies. that a C- average (70% or higher) must be achieved by the end of the course to be accepted by Christian High School and credited toward graduation. BEHAVIOR POLICIES/CHRISTIAN UNIFIED SCHOOLS PHILOSOPHY I commit to: Respect all authorities placed in my life (parents, teachers, staff, and pastors) Diligently strive for academic excellence and perform at my highest standards in all assignments from my parents and teachers. Treat others as Christ would have me treat them. Honor God in everything I do. Abide by the Social Media Policy in the Student Handbook, located on page 19. The Handbook is available on the Christian Unified Website under Student Resources under Documents. I have read the above statements and agree to them as a condition for enrolling in the online course(s) listed above. Both signatures required. Parent or Guardian s Signature Print Name Date Student s Signature Print Name Date 6/01/2011 online_course_agreement.doc

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