For Office Use Only Date Received: Interview Date & Time: Notification of Admittance: APPLICATION FOR ADMITTANCE Name(s) of Student(s) You Wish to Enroll: Full Legal Name Race Gender Birth Date Grade Entering Address Street/Box City State Zip Home Phone #: Cell # (Mother): Cell # (Father): Primary Email Address: Student s extracurricular interests (music, art, athletics, etc.):
List chronologically all schools your child has attended (including nursery and kindergarten): Grade Name Address Dates Grade Name Address Dates Grade Name Address Dates Grade Name Address Dates Has any child you wish to enroll: *Please answer with either yes or no. If yes, please explain and give the child s name. Ever been held back a grade? Been evaluated for learning difficulties? Been recommended for an evaluation due to learning difficulties? Been evaluated for ADD or ADHD? Been recommended for an evaluation due to difficulties with concentration or attention? Received tutoring or other special services? Caused you personal concern related to his/her academic progress? Ever struggled with test anxiety, social anxiety, or anxiety and depression in general? Had or have physical limitations (heart, hearing, speech impediment, nervous condition, etc.)? Had or have chronic illnesses (asthma, ulcers, diabetes, etc.)?
Ever been suspended or expelled? Used alcohol or illegal drugs or had any problems with the law? _ Father's Name Place of Employment Position Phone Cell Number Mother's Name Place of Employment Position Phone Cell Number What is the marital relationship in your home? Please check any that apply. Parents are: married and living together one parent deceased separated divorced Is (are) the student(s) living with at least one parent? yes no. If no, with whom is (are) the student(s) living? Does (do) the student(s) live with one birth parent and a step parent? If so, please give the name of the step parent: If parents are divorced or separated, who has legal custody? Does the other parent have legal right to information from the school? If so, please list a name and address for contact: _ Are there any unusual factors in your child(ren)'s life? (i.e. unusual accidents, serious illness, etc.)? Please comment: EMERGENCY INFORMATION: Family Doctor: Phone: Clinic:
Health Status (please note any specific conditions, allergies, or limitations the school should be aware of): List two NEARBY relatives or friends who will assume temporary care of your child if you cannot be reached: _ Name Address Relationship to Student Phone _ Name Address Relationship to Student Phone We desire to enroll our child(ren) because: How did you hear about Hope Christian Academy? I was referred by: How does your child (ren) feel about attending HCA? Do you understand the meaning of a personal relationship with Jesus Christ? Yes No Do you acknowledge Jesus Christ as your personal Savior and Lord? Yes No If yes, please briefly share how you became a Christian and about your personal relationship with Jesus Christ. STUDENT TESTIMONY To be filled out by the student (K-6 optional, 7-12 mandatory.) Do you have a personal relationship with Jesus Christ? Yes No Explain your relationship with Jesus Christ and how it influences the decisions you make and how you treat others.
I am applying to Hope Christian Academy because: Church Affiliation: Pastor s Name: Attend: regularly occasionally member STATEMENT OF COOPERATION (all statements should be initialed by a parent and 7-12 students) 1. We are willing to have our child(ren) taught in this school in accordance with its philosophy and objectives. INITIALS Parent Student(s) 2. We are in agreement with Hope Christian Academy's Statement of Faith. 3. We hereby agree to accept the rules and regulations of the school, and authorize the staff to administer such disciplinary measures as may be deemed necessary and proper by the administration, in accordance with the school's Discipline Policy. 4. We understand that the school is to make no refunds of registration fees and that tuition payments must be maintained on schedule. We understand that Hope Christian Academy reserves the right to expel our child if he or she fails to comply with established regulations and discipline, or if our financial obligations remain unpaid after the due date. (If this occurs, or he or she is withdrawn, the current month's charges are due and payable, and will not be refunded.) 5. We understand that tuition and fees cover only a portion of the operating expenses, therefore we realize our participation in fund raising events is essential. 6. We are willing to attend Parent Teacher Fellowship meetings as scheduled. 7. Our child may participate in all school activities including field trips away from the school premises. 8. We understand Hope Christian Academy does not tolerate profanity, obscenity in word or action, use of drugs, tobacco, or alcohol. 9. We agree that students are expected to conduct themselves in a respectful manner at all times. 10. We agree that the school has permission to investigate the background of our child(ren) to determine his or her fitness for entrance to Hope Christian Academy.
11. If I, or any member of my immediate family, reach a point of disagreement on an issue of noncriminal nature with Hope Christian Academy and/or its legal corporate entity, in keeping with I Corinthians 6:1, I agree to submit to a board of conciliation, the members of which will be mutually selected by myself and officials of the school, rather than taking the dispute to a civil court. I agree the procedure to be followed, including costs involved, will be that which has been established by the Christian Legal Society. 12. We understand that an asbestos management plan is on file in the school office and that it may be inspected during school hours. NONDISCRIMINATION POLICY Hope Christian Academy admits students of any race, color, national and ethnic origin to all the rights, privileges, programs and activities generally accorded or made available to students at the school. It does not discriminate on the basis of race, color, and national and ethnic origin in administration of its educational policies, admissions policies or scholarship. STATEMENT OF FAITH INITIALS 1. We believe the Bible, in the original writings, is the inerrant word of God given for reproof, correction, and training in righteousness. II Timothy 3:16 We believe in one God, eternally existent in three Persons; God the Father, God the Son, and God the Holy Spirit. Genesis 1:26, Deuteronomy 6:4, Matthew 28:19, John 15:26 2. We believe in the Deity of Jesus Christ, in His virgin birth, His sinless life, His miracles, His vicarious and atoning death through His shed blood, His bodily resurrection, and His Ascension to the right hand of the Father, and His personal, visible return in power and glory at the end of the age. Psalms 2:7-9, Isaiah 7:14, Matthew 11:26, Hebrews 4:14, John 4:10, Hebrews 9:12, Acts 1:3, Matthew 24:27, Acts 1:9-11, Matthew 26:31-34 3. We believe that salvation is a gift of God s grace, and is received by personal faith in the Lord Jesus Christ, totally apart from human merit or works. This salvation is evidenced by Christ-like character, righteous, living and good works, as the believer submits to the indwelling of the Holy Spirit, in obedience to the Word of God. Galatians 5:22-23, Ephesians 2:8-9, I Timothy 1:5, II Timothy 1:9, James 1:21-27 4. We believe in the present ministry of the Holy Spirit by which men are regenerated and granted life and grace to live godly and holy lives in the present evil world. Titus 3:5, Galatians 5:22-23 5. We believe that Satan exists today as the enemy of God and the accuser of God s people. He persistently seeks to counterfeit the works and truth of God. Isaiah 14:12-14, Ezekiel 28:12-17, Acts 26:18, Ephesians 6:10-13, Revelation 12:1-17, Revelation 19:17-21 6. We believe in the personal return of the Lord Jesus Christ. We believe in the bodily resurrection of all the dead; the saved to eternal life, dwelling, forever with Christ; the unsaved to everlasting judgment and condemnation. Matthew 24:29-30, Acts 1:11, Revelation 20:1-6
7. We believe that the true church is a spiritual unity made up of all believers. The church is the body of Christ, composed irrespective of denominational or organizational affiliation. We believe this body of believers was chosen in Christ before the foundation of the world. We neither support nor endorse the World or National Council of Churches, or any world, national, regional, or local organization that give Christian recognition to non-believers or advocate a multi-faith union. Ephesians 1:3-4, Colossians 1:1-18, John 17:20-24, Matthew 28:18-20, I Corinthians 12:13, Ephesians 2:11-22, Ephesians 4:11-16, Colossians 1:28, Hebrews 10:23-25. STATEMENT ON MARRIAGE, GENDER, AND SEXUALITY INITIALS 1. We believe that every person must be afforded compassion, love, kindness, respect, and dignity. Hateful and harassing behavior or attitudes directed toward any individual are to be repudiated and are not in accord with Scripture nor the doctrines of Evangelical Bible Church, and its ministry Hope Christian Academy. Mark 12:28-31; Luke 6:31 2. We believe that God wonderfully and immutably creates each person according to His design and sovereign will. The two distinct, complementary genders of male and female reflect the image and nature of God. Rejection of one s biological sex is a rejection of the image of God within that person. Genesis 1:26-27, Matthew 19:4 3. We believe that the term marriage has only one meaning: the uniting of one biological man and one biological woman in a single, exclusive, lifelong union, as delineated in Scripture. We believe that God intends sexual intimacy to occur only between a man and a woman who are married to each other. We believe that God has commanded that no intimate sexual activity be engaged in outside of a marriage between a man and a woman. Genesis 2:18-25, 1 Corinthians 6:18; 7:2-5; Hebrews 14:4 4. We believe that any form of sexual immorality (including adultery, fornication, homosexual behavior, bisexual conduct, beastiality, incest, polygamy, transgenderism, pedophilia, and use of pornography) is sinful and offensive to God. Matthew 15:18-20; 1 Corinthians 6:9-10 5. We believe that in order to preserve the function and integrity of Evangelical Bible Church as the local Body of Christ, and to provide a biblical role model to HCA and the community, it is imperative that all persons employed by HCA in any capacity, or who serve as volunteers, agree to and abide by this Statement on Marriage, Gender, and Sexuality. Matthew 5:16; Philippians 2:14-16; 1 Thessalonians 5:22 6. We believe that God offers redemption and restoration to all who confess and forsake their sin, seeking His mercy and forgiveness through Jesus Christ. Acts 3:19-21; Romans 10:9-10; 1 Corinthians 6:9-11
Do you have any comments/questions, or are you in disagreement with our Statement of Faith, Mission Statement, or purpose and philosophy as stated in our handbook? HOPE CHRISTIAN ACADEMY STUDENT LIFESTYLE STATEMENT Hope Christian Academy (HCA) is a religious, non-profit Christian school representing Jesus Christ. HCA expects students to conduct themselves in a way that will not raise questions regarding their Christian testimonies. A Christian lifestyle should reflect the biblical perspective of integrity and appropriate personal and family relationships, business conduct and moral behavior. A student is expected to demonstrate a teachable spirit, an ability to share love for others, a willingness to live contentedly under authority and a commitment to follow the Matthew 18 principle when an issue arises with fellow students or school staff. The HCA Statement of Faith and Cooperation expects students to maintain a lifestyle based on biblical standards of moral conduct. Moral misconduct includes, but is not limited to, sexual harassment, promiscuity, homosexual behavior or any other violation of the unique roles of male and female. (Rom. 1:21-27; I Cor. 6:9-20). HCA believes that biblical marriage is limited to a covenant relationship between a man and a woman. HCA students are expected to pursue a lifestyle based on biblical standards of conduct. It is the goal of HCA that each student will have a lifestyle that seeks to honor the Lord Jesus Christ in everyway. Parent Signature Print Name Date Student Signature (Grades 7-12) Print Name Date Student Signature (Grades 7-12) Print Name Date Student Signature (Grades 7-12) Print Name Date