HERITAGE CHRISTIAN SCHOOL A Ministry of Cleveland Baptist Church 4403 TIEDEMAN ROAD BROOKLYN, OHIO 44144 PHONE (216) 476-7976 FAX (216) 476-9140 Applying for Grade Date Application for Enrollment (Please Print) PHOTO (Required) Approved Student's Name Birthdate Sex Last First Middle Address Phone( Street City Zip ) Names and ages of siblings Does applicant know Jesus Christ as Saviour? If so, please give a brief testimony (to be answered by applicant only). Name, address, and phone number of church where student is active member Pastor's Name Name, address, and phone number of school previously attended Do you have any outstanding fees at your former school? How did you hear about our school? Please state your reasons for making application to HCS. Father/Guardian Name _ Daytime Phone( ) Address (if different than student's)
Place of Employment Occupation Does father know Jesus Christ as Saviour? If so, please give a brief testimony. Church Membership Mother/Guardian Name _ Daytime Phone( ) Address (if different than student's) Place of Employment Occupation Does mother know Jesus Christ as Saviour? If so, please give a brief testimony. Church Membership Does applicant [and at least one parent] attend weekly church services? Does applicant have any learning disabilities? Has applicant experienced extreme difficulty in a particular subject area? Has applicant ever repeated any grade level? Does applicant have any mental or physical handicaps? Does applicant have any severe emotional or attitude problems? Has applicant ever been suspended or expelled from school? Has applicant ever been taken to police headquarters or court? Has applicant ever used tobacco, alcohol or drugs? Has applicant ever attended a dance or rock [secular or Christian] concert? Use this space to comment on questions above.
STATEMENT OF COOPERATION We agree to have our child taught according to the biblical convictions of Cleveland Baptist Church. We agree to attend weekly services at a Bible preaching church, preferably one that is Baptistic in doctrine. We give permission for our child to take part in all school activities, including physical education and field trips. We will provide a place at home for our child to study and will encourage him in the completion of all assignments. We agree to encourage our child to respect and obey school officials. We agree to cheerfully cooperate with the school's dress code. We agree to uphold HCS's standards and policies in a positive manner. We grant authority to the school to discipline our child as necessary according to the Parent/Student Handbook. We understand that the school reserves the right to dismiss any student who does not respect its spiritual standards or who refuses to cooperate in the education process. We agree to promptly pay all tuition and fees. We understand that our child will be subject to dismissal if payments are overdue. We understand that assessments will be made to cover loss or damage to school property. We know that report cards and other records will not be released if required payments have not been made. We understand that if our child is withdrawn or expelled from Heritage Christian School, all monies due the school must be paid in full before records will be forwarded to our child's new school. Mother/Guardian's Signature Father/Guardian's Signature Date Date STUDENT QUESTIONNAIRE (to be answered by applicants for grades 4-12) Please complete this questionnaire without assistance from anyone. Leave blank any questions that do not apply to you. List academic subjects of greatest interest to you List academic subjects of least interest to you: How many hours a week do you spend reading, studying, or doing homework? Name two books you have particularly enjoyed in the past year. Give titles and authors. Describe your extracurricular interests and hobbies. Do you have talents or special abilities in a particular area (sports, music, science, etc.)? What do you enjoy doing in your free time? Have you established any long-term goals for your life? On another piece of paper, please provide a one-page handwritten essay on why you wish to attend Heritage Christian School.
ADMISSION POLICY Heritage Christian School, by its own right as a private institution, reserves the privilege of setting and maintaining its own standards for student conduct and scholarship. The following must be completed before your application can be processed: Application & Application Fee Statement of Cooperation Student Questionnaire (Grades 4-12) Pastor's Reference Form School Official's Reference Form Complete the Application in its entirety and return it to the school office with the following: Nonrefundable Application Fee ($5.00 for members of Cleveland Baptist Church; $10.00 for nonmembers). If your child has had previous testing for reading or learning difficulties, include a copy of the report(s)*. Copies of past achievement tests*. A copy of applicant's most recent report card*. * Please do not submit original documents. Complete the top of the Pastor's Reference Form and the School Official's Reference Form and submit them to applicant's current school principal and pastor. Provide a stamped envelope addressed to Heritage Christian School. To ensure confidentiality, these references must be mailed by the pastor and principal directly to the school office. A student's acceptance will be decided by the school administration after a review of the above materials. A student must have a good record of conduct, character and attitude from the school previously attended. All new students will be accepted on a probationary basis. After parents have been notified of the student's acceptance, a Registration Form must be submitted to the church office, accompanied by the nonrefundable Registration Fee. The applicant will not be guaranteed a class position until this process has been completed. Heritage Christian School A Ministry of The Cleveland Baptist Church 4403 Tiedeman Road Brooklyn, Ohio 44144
HERITAGE CHRISTIAN SCHOOL A Ministry of Cleveland Baptist Church 4403 TIEDEMAN ROAD BROOKLYN, OHIO 44144 PHONE (216) 476-7976 FAX (216) 476-9140 To the applicant: Pastor's Reference Form After you complete the first three lines (please print), this form is to be given to your pastor. Please provide a stamped envelope addressed to Heritage Christian School. To ensure confidentiality, this reference must be mailed by the pastor directly to the school office. To the Pastor: The student named above has applied to Heritage Christian School and is requesting that you complete this reference form. We are interested in your estimation of the applicant and his family's spiritual commitment. Your statement will become a part of our confidential admissions file to be used only by those involved in our admission decision process. 1. How long has this family been active members of your church? 2. How many regularly-scheduled services does your church hold each week? 3. On the average, how many services per week does this student attend? 4. On the average, how many services per week do the parents attend? 5. Is this applicant a child with whom you would wish your child to be associated? 6. Would you be at all hesitant to recommend this applicant for enrollment in a Christian school? _ If so, please comment. The following evaluation applies only to applicants for grades 6-12. If you do not feel qualified to answer any of these questions, please refer them to your youth pastor. Please put a check above the characteristic which you feel is most appropriate. INITIATIVE/ INDUSTRY Needs constant Needs occasional Prepares assigned pressure prodding work regularly RESPECT FOR AUTHORITY Occasionally Conforms under Reacts rebellious pressure agreeably JUDGMENT Needs much Usually Exercises counselling cautious common sense CHRISTIAN TESTIMONY Inconsistent Generally good Positive influence
CONDUCT WITH OPPOSITE SEX Questionable Generally good Above reproach HOME ENVIRONMENT Lacking Nominally Spiritually Christian oriented Use this space to comment. Signature of Pastor Printed name of Pastor Telephone Date Thank you for helping us impact young people for Christ. This applicant needs your reference to be considered for enrollment.