Student Information
Name *
Name
Birthday *
Birthday
Has student ever failed a grade?
Has student ever been suspended or expelled?
Does student have a learning disability, 504, IEP, or special education classification?
Has student had any academic or social problems at school?
Does student have any health problems or physical limitations?
Parent/Guardian #1 Information
Name *
Name
Home/Cell Phone *
Home/Cell Phone
Parent or Guardian Signatures
THE INFORMATION ON THIS APPLICATION IS FACTUAL AND ACCURATE TO THE BEST OF MY KNOWLEDGE, AS A PARENT/GUARDIAN, I AGREE TO SUPPORT THE SCHOOL’S STANDARD OF CONDUCT AND OTHER REGULATIONS CONCERNING STUDENTS WHILE MY CHILD IS IN SUMMIT CHRISTIAN ACADEMY. I ALSO AGREE TO PAY MY CHILD’S TUTITION IN A TIMELY MANNER.
eSigned Date *
eSigned Date