APPLICATION FOR ADMISSION
School Year: _____________
New students are required to present proof of date of birth and all students must provide proof of current immunizations.
STUDENT INFORMATION
Full legal name ______________________________________________________________
Mailing Address _____________________________________________________________
Physical Address (if different) __________________________________________________
Phone __________________ Age _____________ Entering grade _____________________
Date of birth ________________________Place of birth ____________________________
School previously attended ___________________________________________________
Church preference __________________________________________________________
PARENT INFORMATION
Father’s name _________________________ Occupation ____________________________
Mailing Address ____________________ Physical Address ___________________________
Home Phone _____________________ Work Phone __________________________
Cell Phone _______________________ E-mail_______________________________
Mother’s name ________________________ Occupation ____________________________
Mailing Address ____________________ Physical Address ___________________________
Home Phone _______ _______________ Work Phone_________________ ________
Cell Phone _______________________ E-mail_______________________________
IN CASE OF EMERGENCY
Name______________________________ Phone ____________________________________
Physician __________________________ Phone_____________________________________
Commitment
I have read the policies governing the Enterprise SDA Church School and will cooperate with them. I accept responsibility for my financial commitment of $_______ monthly. Registration fee is $150.00, per student, and is payable at registration. Each month’s commitment is to be paid by the second week of each month, September through May.
Please make checks payable to: Enterprise SDA
_______________________________________________ ____________________
Signature of parent Date
New Student
References 1. ________________________________________________________________
2. ________________________________________________________________
3. ________________________________________________________________
