FHCA Off-Campus Application Form

** PLEASE NOTE **

>> Completing this form requires a payment of application fees using a credit card or an e-check. <<

IF YOU DO NOT WISH TO PAY YOUR FEES IN THIS MANNER,

YOU WILL HAVE TO DOWNLOAD/PRINT OUT THE FORMS AND FILL ONE OUT PER CHILD

THEN MAIL IT IN WITH THE PROPER FEES.

The forms to download may be found on our website at faithheritage.com

Click on Off Campus at the top level menu.

Then select Forms from the dropdown to choose what you wish to download.
FAITH HERITAGE CHRISTIAN ACADEMY

Off-Campus Application for Admission (please complete ALL parts)
FaithHeritage Christian Academy (FHCA) admits students of any race, color, national or ethnic origin to all the rights, privileges, programs, and activities generally accorded or made available to students at the school. FHCA does not discriminate on the basis of race, color, national and ethnic origin in the administration of its educational policies, admission policies, scholarship and loan programs, athletic and other school administered programs.

Important:

**We are NOT accepting NEW 12th grade off-campus students for the 2022-23 school year.

**All Kindergarten students must submit a copy of their birth certificate and immunization when applying for enrollment. Thank you for understanding.

To make it convenient, we have included a section where you may upload necessary forms as you complete this application.
School Year: *
Main Email You Want Associated with This Application: *
example@example.com
County of Residence: *
School District in which Family Resides: *
Parental & Family Information
Family Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Father's Name:
Father's Occupation/Title:
Father's Address (If different from above):

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Father's Work or Cell Phone:
Father's E-mail:
Grandparents Name and Mailing Address (Father):
Mother's Name:
Mother's Occupation/Title:
Mother's Address (If different from above):

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Mother's Work or Cell Phone:
Mother's E-mail:
Grandparents Name and Mailing Address (Mother):
Church Family Presently Attends
Pastor's Name
Does your family attend church on a regular basis?

Yes No
Person Authorized to Contact In Emergency

(If a parent cannot be contacted)
Emergency Contact Name: *
Contact Phone: *
Relationship: *
For How Many Children Are You Applying? *
Please enter a number from 1 to 7

STUDENT INFORMATION
Please classify this Application as either "New" or "Renewal" *

New Renewal
Student's Full Name: *
Applying for Grade:
Gender: *

Female Male
Birthdate *

Month Day Year
Date
Age: *
Has this student ever been enrolled at FHCA before - on or off-campus? *

Yes No
Previous School Attended (If different from FHCA):
County / School District:
School Address:
Reason For Leaving:
GENERAL INFORMATION
What are the special needs (if any) or accommodations for your child?
What are the special talents of your child?
Has this student ever repeated a grade? If yes, please discuss here:
Has this student ever had disciplinary difficulties in school? If yes, please discuss here:
Has this student ever been recommended for special education, been diagnosed with a learning disability, had any childhood illnesses which might impair his/her ability to learn or been recommended for drug or alcohol treatment? If yes, please discuss here:
Is there anything else you'd like us to know about this student? If yes, please discuss here:
What are your objectives for your child as a student at FaithHeritage Christian Academy?
STUDENT DOCUMENTS
- For New Students:
  - Birth certificate
  - Immunization records
  - Report card from past school year
  - Withdrawal Form if transferring during the School Year
- For All Students:
  - Curriculum Form
  - Completed Report Card
  - Dual Enrollment Transcript/Grade Report
  - Educational / Psychological Evaluation Report
  - IEP or 504 Plan
Click in the field below to upload:

Add as many as you need. No file to exceed 50 MB.
Cancel of
Do you have another child to add to this application? *

STUDENT #2: BASIC INFORMATION
Please classify this Application as either "New" or "Renewal" *

New Renewal
Student's Full Name: *
Applying for Grade:
Gender: *

Female Male
Birthdate *

Month Day Year
Date
Age: *
Has this student ever been enrolled at FHCA before - on or off-campus? *

Yes No
Previous School Attended (If different from FHCA):
County / School District:
School Address:
Reason For Leaving:
STUDENT #2: GENERAL INFORMATION
What are the special needs (if any) or accommodations for your child?
What are the special talents of your child?
Has this student ever repeated a grade? If yes, please discuss here:
Has this student ever had disciplinary difficulties in school? If yes, please discuss here:
Has this student ever been recommended for special education, been diagnosed with a learning disability, had any childhood illnesses which might impair his/her ability to learn or been recommended for drug or alcohol treatment? If yes, please discuss here:
Is there anything else you'd like us to know about this student? If yes, please discuss here:
What are your objectives for your child as a student at FaithHeritage Christian Academy?
STUDENT #2: DOCUMENTS
- For New Students:
  - Birth certificate
  - Immunization records
  - Report card from past school year
  - Withdrawal Form if transferring during the School Year
- For All Students:
  - Curriculum Form
  - Completed Report Card
  - Dual Enrollment Transcript/Grade Report
  - Educational / Psychological Evaluation Report
  - IEP or 504 Plan
Click in the field below to upload:

Add as many as you need. No file to exceed 50 MB.
Cancel of
Do you have another child to add to this application? *

STUDENT #3: BASIC INFORMATION
Please classify this Application as either "New" or "Renewal" *

New Renewal
Student's Full Name: *
Applying for Grade:
Gender: *

Female Male
Birthdate *

Month Day Year
Date
Age: *
Has this student ever been enrolled at FHCA before - on or off-campus? *

Yes No
Previous School Attended (If different from FHCA):
County / School District:
School Address:
Reason For Leaving:
STUDENT #3: GENERAL INFORMATION
What are the special needs (if any) or accommodations for your child?
What are the special talents of your child?
Has this student ever repeated a grade? If yes, please discuss here:
Has this student ever had disciplinary difficulties in school? If yes, please discuss here:
Has this student ever been recommended for special education, been diagnosed with a learning disability, had any childhood illnesses which might impair his/her ability to learn or been recommended for drug or alcohol treatment? If yes, please discuss here:
Is there anything else you'd like us to know about this student? If yes, please discuss here:
What are your objectives for your child as a student at FaithHeritage Christian Academy?
STUDENT #3: DOCUMENTS
- For New Students:
  - Birth certificate
  - Immunization records
  - Report card from past school year
  - Withdrawal Form if transferring during the School Year
- For All Students:
  - Curriculum Form
  - Completed Report Card
  - Dual Enrollment Transcript/Grade Report
  - Educational / Psychological Evaluation Report
  - IEP or 504 Plan
Click in the field below to upload:

Add as many as you need. No file to exceed 50 MB.
Cancel of
Do you have another child to add to this application? *

STUDENT #4: BASIC INFORMATION
Please classify this Application as either "New" or "Renewal" *

New Renewal
Student's Full Name: *
Applying for Grade:
Gender: *

Female Male
Birthdate *

Month Day Year
Date
Age: *
Has this student ever been enrolled at FHCA before - on or off-campus? *

Yes No
Previous School Attended (If different from FHCA):
County / School District:
School Address:
Reason For Leaving:
STUDENT #4: GENERAL INFORMATION
What are the special needs (if any) or accommodations for your child?
What are the special talents of your child?
Has this student ever repeated a grade? If yes, please discuss here:
Has this student ever had disciplinary difficulties in school? If yes, please discuss here:
Has this student ever been recommended for special education, been diagnosed with a learning disability, had any childhood illnesses which might impair his/her ability to learn or been recommended for drug or alcohol treatment? If yes, please discuss here:
Is there anything else you'd like us to know about this student? If yes, please discuss here:
What are your objectives for your child as a student at FaithHeritage Christian Academy?
STUDENT #4: DOCUMENTS
- For New Students:
  - Birth certificate
  - Immunization records
  - Report card from past school year
  - Withdrawal Form if transferring during the School Year
- For All Students:
  - Curriculum Form
  - Completed Report Card
  - Dual Enrollment Transcript/Grade Report
  - Educational / Psychological Evaluation Report
  - IEP or 504 Plan
Click in the field below to upload:

Add as many as you need. No file to exceed 50 MB.
Cancel of
Do you have another child to add to this application? *

STUDENT #5: BASIC INFORMATION
Please classify this Application as either "New" or "Renewal" *

New Renewal
Student's Full Name: *
Applying for Grade:
Gender: *

Female Male
Birthdate *

Month Day Year
Date
Age: *
Has this student ever been enrolled at FHCA before - on or off-campus? *

Yes No
Previous School Attended (If different from FHCA):
County / School District:
School Address:
Reason For Leaving:
STUDENT #5: GENERAL INFORMATION
What are the special needs (if any) or accommodations for your child?
What are the special talents of your child?
Has this student ever repeated a grade? If yes, please discuss here:
Has this student ever had disciplinary difficulties in school? If yes, please discuss here:
Has this student ever been recommended for special education, been diagnosed with a learning disability, had any childhood illnesses which might impair his/her ability to learn or been recommended for drug or alcohol treatment? If yes, please discuss here:
Is there anything else you'd like us to know about this student? If yes, please discuss here:
What are your objectives for your child as a student at FaithHeritage Christian Academy?
STUDENT #5: DOCUMENTS
- For New Students:
  - Birth certificate
  - Immunization records
  - Report card from past school year
  - Withdrawal Form if transferring during the School Year
- For All Students:
  - Curriculum Form
  - Completed Report Card
  - Dual Enrollment Transcript/Grade Report
  - Educational / Psychological Evaluation Report
  - IEP or 504 Plan
Click in the field below to upload:

Add as many as you need. No file to exceed 50 MB.
Cancel of
Do you have another child to add to this application? *

STUDENT #6: BASIC INFORMATION
Please classify this Application as either "New" or "Renewal" *

New Renewal
Student's Full Name: *
Applying for Grade:
Gender: *

Female Male
Birthdate *

Month Day Year
Date
Age: *
Has this student ever been enrolled at FHCA before - on or off-campus? *

Yes No
Previous School Attended (If different from FHCA):
County / School District:
School Address:
Reason For Leaving:
STUDENT #6: GENERAL INFORMATION
What are the special needs (if any) or accommodations for your child?
What are the special talents of your child?
Has this student ever repeated a grade? If yes, please discuss here:
Has this student ever had disciplinary difficulties in school? If yes, please discuss here:
Has this student ever been recommended for special education, been diagnosed with a learning disability, had any childhood illnesses which might impair his/her ability to learn or been recommended for drug or alcohol treatment? If yes, please discuss here:
Is there anything else you'd like us to know about this student? If yes, please discuss here:
What are your objectives for your child as a student at FaithHeritage Christian Academy?
STUDENT #6: DOCUMENTS
- For New Students:
  - Birth certificate
  - Immunization records
  - Report card from past school year
  - Withdrawal Form if transferring during the School Year
- For All Students:
  - Curriculum Form
  - Completed Report Card
  - Dual Enrollment Transcript/Grade Report
  - Educational / Psychological Evaluation Report
  - IEP or 504 Plan
Click in the field below to upload:

Add as many as you need. No file to exceed 50 MB.
Cancel of
Do you have another child to add to this application? *

STUDENT #7: BASIC INFORMATION
Please classify this Application as either "New" or "Renewal" *

New Renewal
Student's Full Name: *
Applying for Grade:
Gender: *

Female Male
Birthdate *

Month Day Year
Date
Age: *
Has this student ever been enrolled at FHCA before - on or off-campus? *

Yes No
Previous School Attended (If different from FHCA):
County / School District:
School Address:
Reason For Leaving:
STUDENT #7: GENERAL INFORMATION
What are the special needs (if any) or accommodations for your child?
What are the special talents of your child?
Has this student ever repeated a grade? If yes, please discuss here:
Has this student ever had disciplinary difficulties in school? If yes, please discuss here:
Has this student ever been recommended for special education, been diagnosed with a learning disability, had any childhood illnesses which might impair his/her ability to learn or been recommended for drug or alcohol treatment? If yes, please discuss here:
Is there anything else you'd like us to know about this student? If yes, please discuss here:
What are your objectives for your child as a student at FaithHeritage Christian Academy?
STUDENT #7: DOCUMENTS
- For New Students:
  - Birth certificate
  - Immunization records
  - Report card from past school year
  - Withdrawal Form if transferring during the School Year
- For All Students:
  - Curriculum Form
  - Completed Report Card
  - Dual Enrollment Transcript/Grade Report
  - Educational / Psychological Evaluation Report
  - IEP or 504 Plan
Click in the field below to upload:

Add as many as you need. No file to exceed 50 MB.
Cancel of

FAITH HERITAGE CHRISTIAN ACADEMY

Parental & Family Information

Person Authorized to Contact In Emergency

STUDENT INFORMATION

GENERAL INFORMATION

STUDENT DOCUMENTS

STUDENT #2: BASIC INFORMATION

STUDENT #2: GENERAL INFORMATION

STUDENT #2: DOCUMENTS

STUDENT #3: BASIC INFORMATION

STUDENT #3: GENERAL INFORMATION

STUDENT #3: DOCUMENTS

STUDENT #4: BASIC INFORMATION

STUDENT #4: GENERAL INFORMATION

STUDENT #4: DOCUMENTS

STUDENT #5: BASIC INFORMATION

STUDENT #5: GENERAL INFORMATION

STUDENT #5: DOCUMENTS

STUDENT #6: BASIC INFORMATION

STUDENT #6: GENERAL INFORMATION

STUDENT #6: DOCUMENTS

STUDENT #7: BASIC INFORMATION

STUDENT #7: GENERAL INFORMATION

STUDENT #7: DOCUMENTS

Application Fees Payment

Credit Card

Disclaimers & Signatures

Enter coupon