North Central Texas Academy Domestic Student Application

Student Name*

First NameLast Name

Age*

Gender*

MaleFemale

Date of Birth*

Date

How did you hear about North Central Texas Academy?*

Please upload a current photograph of the student.*

Phone Number

Please enter a valid phone number.

Email*

example@example.com

City of Birth*

Country of Birth*

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Upload a scanned copy of the applicant's birth certificate*

Upload a scanned copy of the applicant's social security card.*

Current grade Level*

Applying for grade level*

School Last Attended*

School Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Has the applicant ever repeated a grade?*

YesNo

If yes, what grade(s) and why?

Describe the applicant's academic and behavioral strengths.*

Describe the applicant's academic and/or behavioral weaknesses.*

Has the applicant experienced any academic or behavioral difficulties in school? If so, please describe.*

Has the applicant ever been suspended, expelled or withdrawn? If so, please explain.*

Scan and upload the applicant's end of year report card from the previous two school years and/or a copy of the student's official high school transcript.*

Upload standardized achievement testing from the last three years. *

Religious affiliation*

Current church/Congregation, include city and country*

How often are you involved in a church?*

WeeklyMonthlyOccasionallyNever

Parent/Guardian's Name - Primary*

First NameLast Name

Phone Number

Please enter a valid phone number.

Parent email address*

Occupation*

Parent/Guardian's Name - Secondary

First NameLast Name

Phone Number

Please enter a valid phone number.

Occupation

Does the applicant have any siblings?*

Please list any siblings name(s) and their date of birth below.

Boarding tuition is $49,000/year. The price includes tuition and boarding. A limited amount of scholarship money is available for families with financial need. Do you intend on applying for a scholarship? If yes, please email a.schwausch@nctapioneers.org to receive the application. Families who do not submit proper documentation will not be considered for financial assistance.*

YesNo

Agriculture

Caring for animalsLivestock showingHorseback riding

Athletics

Boys basketballVolleyballBoys soccer

Fine Arts

Please describe your level of experience for the activities marked above or other activities in which you are involved. Include any awards or honors you have received. *

Please describe any emotional or behavioral problems the applicant has had at home or in the community.*

Has the applicant ever received counseling, academic remediation, speech and language therapy, or occupational therapy at school or in the community? If yes, please describe.*

Has the applicant ever undergone any psychoeducational evaluation, testing or psychiatric hospitalization? If yes, please describe.*

If the student have any allergies, please list them down below:*

Does the student currently taking any medications? If yes, please list them down below:*

Was the student previously hospitalized or undergo any surgery?*

Does the student have any medical conditions? List all known below.*

Does the applicant have any special dietary restrictions? If yes, please explain.*

Upload the student's immunization records below.*

Physical form: please find the physical form at the website below, then upload the completed form. https://www.uiltexas.org/files/athletics/forms/PrePhysFormRvsd1_10_20.pdf*

PARENT AGREEMENT I understand the following conditions of admission required from North Central Texas Academy:1. The student and parents agree to uphold the core values of North Central Texas Academy and strive to grow in demonstrating responsibility, respect, personal integrity, self-discipline, and love for others at all times. 2. North Central Texas Academy forbids the use of alcohol, tobacco, and illegal drugs by students both on and off campus. Possession or use of alcohol, tobacco or illegal drugs on or off campus will be grounds for dismissal or other disciplinary measures.3. Education is a cooperative undertaking among the school, the parents, and the student. I agree to support the mission, policies, and educational philosophy of North Central Texas Academy on and away from campus. Failure to do so will be grounds for dismissal or contract non-renewal. 4. I authorize North Central Texas Academy to contact current and previous schools or other sources to obtain information to support this application. I agree not to seek access to confidential recommendations or evaluation materials provided by previous schools, administrators, counselors, pastors, or other sources before or after admission. I agree to the above conditions of admission by typing my name below.

Signature to verify parent agreement above. *

NCTA Student Honor Code

North Central Texas Academy strives to provide an atmosphere in which students develop intellectually, socially, spiritually, and physically. In order to create this atmosphere, the core values of respect, responsibility, personal integrity, self control, and love for one another are taught and modeled. It is our expectation that all NCTA students uphold the student code of conduct displayed below. The North Central Texas Academy student code of conduct is supported by the Statement of Faith, which is based upon the Word of God, the Holy Bible. Because I want to be a person of integrity and honorable character, and I want to be a member of The North Central Texas Academy community, I will choose to model my life, both on and off campus, by following the NCTA Student Code of Conduct. I make a personal commitment to:· Cooperate respectfully with those in authority· Strive for excellence as a student· Seek to build relationships with people of high moral character· Care for and respect others and their property· Be truthful, trustworthy, and appropriate in my words and actions· Be pure and upright in my relationships, not involving myself in sexual misconduct · Choose modes of entertainment that are Christ honoring, avoiding the appearance of evil· Refrain from any form of cheating· Totally abstain from the use or possession of tobacco, drugs, pornography or alcohol· Display my character with integrity and respect through all social media applications On my word of honor, I will respect the NCTA Student Code of Conduct and I will actively work to uphold its high standards. I shall do my best to be a good citizen of North Central Texas Academy. I realize that I may be suspended or expelled from school, or asked not to return the following year, if I do not uphold the Student Code of Conduct, the spirit, or the policies of the school--whether on or off property--as determined at the sole discretion of the Administration. If you can agree to these expectations sign (type) your name below.

Signature*

Name of parent(s) completing this application*

Is the applicant adopted? If so, please include the date of the adoption.*

Please describe the applicant's family situation and history. Include any information the should be aware of.*

Has the applicant ever lived away from home? *

What has been the biggest academic and/or extracurricular challenge for the student?*

Why do you want this student to attend North Central Texas Academy? What are your expectations of NCTA?*

Although students come from many religious backgrounds, NCTA is a Christian academy. Students attend chapel weekly and take Bible classes in grades K-12. Please describe your religious background and your view on Christian education. *

List and describe your level of interest and participation in school activities.*

What are some of your goals in life?*

How can NCTA help you to meet these goals?*

Describe your faith and how you feel about attending a Christian academy.*

Describe your thoughts and feelings about moving away from home and attending NCTA.*

Parent/Guardian Signature

Date Signed

Date

North Central Texas Academy

School Information

School Records

Religious Affiliation

Parent/Guardian's Information

Financial Assistance

Student Interests

Additional Student Information

Health History

Immunization Requirements:

Parent Questionnaire

Student Questionnaire

Electronic signature