Admission Application

Transcription

1 Admission Application Office: Fax: P.O. Box 206 Alamo, TX 78616

2 APPLICATION CHECKLIST CHECKLIST FOR APPLICATION Step 1: In order to apply, the following must be completed and/or given to the school office. Student Application Church Involvement Form Medical History Form Parental and Student Commitment Form Financial Agreement Form School Records Release Form School Permissions Form Sport Physical or Athletic Release Form Immunization Records Copy of Student s Birth Certificate Copy of Student s Social Security Card Student s Current Report Card (K4 8 th grade) Student s Transcript (9 th 12 h grade) Schedule academic testing date with MCA office and pay the testing fee of $ For international students (attending with an I20 form), pay the non-refundable application fee of $50 per student Step 2: References (required) One (1) reference from your pastor One (1) reference from a ministry leader whom your family serves under Step 3: You will be contacted to schedule a family interview. Please be prepared for your interview by reading and becoming familiar with the following: Student Handbook - Available online at A hard copy will be given out at registration. Parental and Student Commitment Form Upon completion of your interview, you will be contacted regarding the conclusion of the application process. If accepted, the non-refundable registration fee of $ 50 must be received in order to reserve enrollment. If you have any further questions or comments, please do not hesitate to contact us at Treasuring Christ, Santiago W. Curling Administrator

3 APPLICATION FOR ADMISSION STUDENT INFORMATION Last Name First M.I. Street Address Apartment/Unit # City State ZIP Phone of Birth Applying for grade Social Security No. Address Applying for academic Year Country of Citizenship Student Resides With Both Parents Father Mother Other FAMILY INFORMATION Check One: Father Stepfather Guardian Last Name First M.I. Address City State ZIP Home Phone ( ) Cell Phone ( ) Work Phone ( ) Marital Status Never Married Married Separated Divorced Divorced and Remarried Widower Employer Position Check One: Mother Stepmother Guardian Last Name First M.I. Address City State ZIP Home Phone ( ) Cell Phone ( ) Work Phone ( ) Marital Status Never Married Married Separated Divorced Divorced and Remarried Widower Employer Position Please list names and ages of siblings living at home (if not applying) Name Age School Attending Name Age School Attending Name Age School Attending Please give the reason siblings are not applying

4 EDUCATIONAL INFORMATION: Please give complete information regarding the last school your child attended. School Name Address City State ZIP Attended From To Type of School Public Homeschool Christian Private Other: School Phone Current Grade Has your child ever been placed on probation, denied enrollment, suspended, or expelled for disciplinary reasons by any school? YES NO Has your child ever used alcohol, a non-medical drug, or tobacco? YES NO Has your child ever been arrested for something other than a traffic violation? YES NO Has your child ever failed an academic subject in school? YES NO If yes to any of the above, please explain: Please indicate academic level of student s previous work? Excellent Good Average Poor Has your child ever been diagnosed with any academic needs? YES NO If yes, please explain ADMISSIONS POLICY We may request that your student be tested for academic placement purposes based upon submitted grades/transcript in order to best support their current level of learning and be successful in the year ahead. All new students are enrolled on a nine-week probationary period which gives an opportunity to evaluate the student s spiritual attitude, academic achievement, and ability to discipline himself/herself. If a student is unable to compete on his/her grade level, Macedonian Christian Academy reserves the right to place him/her in a lower grade. If the student has problems which the school cannot help, he/she will be dismissed by the end of the probationary period. A student who does not agree or cooperate with the purpose and program of the school will not be admitted or allowed to remain in the school. Macedonian Christian Academy does not discriminate on the basis of race or national origin. ENROLLMENT AGREEMENT I have read the informational materials furnished and agree to insist that my child submit to the program, academic and disciplinary regulations, and all other requirements instituted by the administration and carried out by the principal and faculty. Signature of Mother Signature of Father Application must be completed before it can be processed. An interview with the parents and the child will be required before final acceptance. Registration fee of $ 50 and testing fee of $ must accompany application and is non-refundable. OFFICE USE ONLY received Interviewed Interviewer Records requested YES NO Requested by Records received YES NO Received by

5 STATEMENT OF CHURCH INVOLVEMENT FAMILY CHURCH INFORMATION (to be completed by parents) Church Name Phone ( ) Address Pastor Denomination Web Address Describe your church attendance: Weekly (1-3 times per week) Occasionally (1-2 times per month) Rarely (less than once per month) Never Are you a member of this church? YES NO If no, please provide the church name and address where you are a member. Church Name Phone ( ) Address Pastor Denomination Web Address Father: Christian? YES NO Mother: Christian? YES NO STUDENT SPIRITUAL INFORMATION (to be completed by student) Have you ever made a profession of Faith? YES NO Are you active in your church and youth group? YES NO If yes, please describe your activities: If no, please explain: If you were to stand before God and He asked you why He should let you into heaven, what Scriptural reason(s) would you give? What in your life indicates that you are a Christian? I certify that the information given on this application is complete and accurate. Applicant s signature

6 MEDICAL HISTORY FORM MEDICAL INFORMATION Family Physician Phone ( ) It is mandatory that students who exhibit symptoms of a communicable disease be excluded from classes until readmission is deemed acceptable by the school s educational leaders. Your cooperation will be greatly appreciated. Does student have any physical limitations or medical conditions? YES NO If yes, please explain: Please mark the following immunizations your child has received: Diphtheria Small Pox Polio Please indicate if your child has had or currently has any of the following: Allergies (food, insects, drugs, latex) Developmental problems Muscle problems Allergies (seasonal) Diabetes Polio Asthma or breathing problems Fatigue Rheumatic Fever Attention-Deficit/Hyperactivity Disorder Fainting or dizziness Ringworm Behavioral problems Head injury, concussions Scarlet Fever Bladder problem Hearing problems, deafness Seizures Bleeding problem Heart problems Sickle Cell Disease Bowel problem Hernia (ruptures) Speech problems Cerebral Palsy Lead poisoning Spinal injury Chicken Pox Measles Surgery Cystic fibrosis Mono Vision problems Dental problems Mumps Whooping Cough If you selected any of the above, please explain (for illnesses, injuries, etc., include the year and/or your child s age at the time): Please describe any other important health-related information about your child: Immunization Record Please attach a copy of student s immunization record. Student Insurance Record Name of Company Policy Number Address City State ZIP Effective Expiration Parent/Guardian signature

7 COMMITMENT FORM PARENTAL AND STUDENT AGREEMENT I understand that MCA will teach the Bible and base all of its teachings on the understanding that the Bible is the inspired, inerrant, Word of God, and that it is our guide for all facets of life. I understand that my child(ren) will be taught that salvation and a relationship with God comes only through individual faith in the person and work of Jesus Christ, and that my child(ren) will be instructed and encouraged to live for Christ in their thoughts, conversations, and actions. I understand that my child(ren) will be encouraged to participate regularly in Bible reading, study, and prayer. I commit to making weekly worship and Biblical instruction a sacred commitment in my family. I understand the need for home and school to work together in a common goal of nurture and education. I understand that MCA s mission originates and extends from the Christian home through good communication and accountability and that this understanding will characterize the home to school relationship. I understand that MCA has full discretion in the discipline of my child(ren) within the guidelines of the discipline policy as described in the MCA Student Handbook. I understand that MCA reserves the right to refuse any application at any time if it is determined by the school administration that the applicant is not suited to the program offered by the school. MCA further reserves the right to dismiss any student whose academic performance or whose conduct does not meet the standards set forth in the MCA Student Handbook. I agree to support the school, to the best of my ability, in faithful prayer for the kingdom work of the school and by offering practical help and resources to the school. I agree to support and encourage the spiritual, academic, moral, dress, and discipline standards of MCA as set forth in the policies of the MCA Student Handbook. I agree to allow my child(ren) to participate in all required field trips and school activities while school is in session. Parent signature Parent signature Student signature

8 FINANCIAL AGREEMENT FORM FEE SCHEDULE AND AGREEMENT REGISTRATION FEE: $275 per student due at registration, non-refundable. If you paid the $50 reservation fee, it will be applied toward your $275 reservation fee. TUITION FEE: Tuition payments are billed over a 9-month period starting in September. All tuition payments are handled by Smart Tuition. Tuition for ALL grades is $275 per child. Each additional child is discounted by $15 per child. Discounts are calculated starting with the oldest child and working down to the youngest. MISCELLANEOUS FEES: (the following fees are estimates) Jr/Sr Trip (11 th 12 th grade only) $500 Graduation gown and picture (12 th grade only) $100 Band Fundraiser $100 Stanford Achievement Testing (SAT) $20 Athletics (optional): Basketball Playoff Games (9 th 12 th grade team) Basketball Tournament 5 days (9 th 12 th grade team) $100 $50/game Your registration fees are $. Your tuition fees are $. If you are receiving financial aid for this academic year, the amount of aid awarded your family is $. This brings your total tuition fees, less your financial aid, for this year to $, which comes to $ /month to be paid during the 9-month period of September - May. Tuition fees may be prepaid; however, partially completed months are non-refundable (for example, if a student leaves the school on December 5 th, December s tuition is not refundable, but all months after that would be refunded). I (we) agree to the above terms. Signature Signature

9 RECORDS RELEASE FORM STUDENT INFORMATION I HEREBY REQUEST RELEASE OF THE FOLLOWING STUDENT RECORDS. PLEASE INCLUDE GRADES, STANDARDIZED TEST SCORES, ATTENDANCE AND MEDICAL RECORDS. Last Name First M.I. Street Address Apartment/Unit # City State ZIP Phone of Birth Social Security No. Address SCHOOL PREVIOUSLY ATTENDED School Name Street Address Apartment/Unit # City State ZIP Grade If not enrolled last year, please specify dates of last attendance RECORDS ARE TO BE SENT TO: Macedonian Christian Academy Attention: Santiago Curling P.O. Box 206 Alamo, Texas Phone: Fax: *Please call before sending fax documents PLEASE INCLUDE ANY OTHER SIGNIFICANT INFORMATION REGARDING THIS STUDENT Note: Parental permission is no longer required by authorized school personnel. (Family Educational Rights and Privacy Act. Final rule on education records. Federal register June 17, 1976, Vol. 41 No. 118, Page 24673).

10 PERMISSIONS FORM FIELD TRIP PERMISSION Occasionally your child will be a part of a field trip, privilege outing, and/or honor roll party sponsored by Macedonian Christian Academy. While those responsible for the trip will exercise care to prevent accidents on trips, it is understood that in giving permission, claims against the institution, teacher, and related parties are waived. My child has my permission to attend schoolsponsored outings. Parent Initials EMERGENCY PERMISSION If my child is involved in a serious accident or injury and I cannot be reached, I give my permission to call the family physician listed on the medical form. I will assume responsibility for payment of any additional expenses not covered by insurance. Parent Initials MEDICATION PERMISSION I give my permission for the following medication to be administered to my child if headache or discomfort occurs while at school. Aspirin Ibuprofen (Motrin) Acetaminophen (Tylenol) Pepto Bismol Other Parent Initials STUDENT HANDBOOK/PARENTAL AND STUDENT COMMITMENT I have read and understood the policies and rules as outlined in the Student Handbook/Parental and Student Commitment Form. Parent Initials Student Initials Signature of Parent

11 ATHLETIC RELEASE FORM (Required for all students planning to participate in sports.) PREPARTICIPATION PHYSICAL EXAMINATION (to be completed by licensed physician, licensed osteopathic physician, licensed chiropractic physician, licensed physician assistant or certified advanced registered nurse practitioner) Student s Name Height Weight Male Female Temperature Hearing RIGHT P F LEFT P F BP / ( / ) Pulse Vision R20/ L20/ Corrected YES NO MEDICAL NORMAL ABNORMAL FINDINGS Appearance Eyes/ears/nose/throat Lymph Nodes Heart Pulses Lungs Abdomen Genitalia (for males only) Skin Neurologic MUSCULOSKELETAL NORMAL ABNORMAL FINDINGS Neck Back Shoulder/Arm Elbow/forearm Wrist/hand/fingers Hip/thigh Knee Leg/ankle Foot/toes ASSESSMENT OF EXAMINING PHYSICIAN I hereby certify that each examination listed above was performed by myself or an individual under my direct supervision with the following conclusion(s): Cleared without limitation YES NO Disability Diagnosis Precautions Not cleared for Reason Cleared after completing evaluation/rehabilitation for Referred to Physicians signature For

12 UNIFORM ORDERING GUIDE ELEMENTARY GIRLS (K-3 to 6 th Grade) Style Color Item # Purchase from French Toast Sweater Vest Must have embroidered logo* Navy/Red 1029 YES** Polo or Blouse Must have collar, long/short sleeve White N/A NO Plaid Pleated Skirt Blue/Gold or Blue/Red 1065 YES Jumper Navy/Khaki 1285 YES** Shoes No opened toed shoes (i.e. flip flops, sandals, or crocs) K-3 TO K-5 GIRLS (OPTIONAL) Skorts (Two Tab Plaid Scooter) Must be worn with embroidered vest Blue/Gold or Blue/Red 1397 YES MIDDLE/HIGH SCHOOL GIRLS (7 TH to 12 TH Grade) Sweater Vest Must have embroidered logo* Navy/Red 1029 YES Polo or Blouse Must have collar, long/short sleeve White N/A NO Plaid Pleated Skirt Blue/Gold or Blue/Red 1065 YES Shoes No opened toed shoes (i.e. flip flops, sandals, or crocs) ELEMENTARY BOYS (K-3 to 6 th Grade) Polo Must have embroidered logo* Navy/Red N/A NO Jeans (No cargo, torn, or stone washed jeans) Must be worn with a belt Dark Blue N/A NO Shoes No open toed shoes (i.e. flip flops, sandals, or crocs) MIDDLE/HIGH SCHOOL BOYS (7 TH to 12 th Grade) Polo Must have embroidered logo* Navy/Red N/A NO Pants/Slacks (No cargo or torn pants) Must be worn with a belt Navy/Khaki N/A NO Shoes- No open toed shoes (i.e. flip flops, sandals, or crocs) GIRLS AND BOYS P.E. UNIFORM (K-5 to 12 th Grade) Dark athletic shorts to the knee School made P.E. Shirt *Sweater Vests and Polos should be embroidered at Enzzo Sport This company has the MCA logo on file. **Plaid Pleated Skirts and Jumpers must be purchased from French Toast uniform supply. Order online at (source code for MCA is QS5XJRE) or call