Clone of RPCA Grade School Application

Ragin Preparatory Christian Academy admits students of any race, color, national or ethnic origin to all rights, privileges, programs, and activities generally accorded or made available to students at the school. Ragin Preparatory Christian Academy does not discriminate on the basis of race, color, national or ethnic origin in administration of its educational policies, admissions policies, or other school administered programs.

Admissions Policies
1. Ragin Preparatory Christian Academy admits students of any race, color, national or ethnic origin to all rights, privileges, programs, and activities generally accorded or made available to students at the school. Ragin Preparatory Christian Academy does not discriminate on the basis of race, color, national or ethnic origin in administration of its educational policies, admissions policies, and other school administered programs.

2. For first grade, a child must be of age before September 2nd .

3. Application process:
● Must apply and pay $25 application fee (No application will be considered without the application fee.)
● Provide a copy of the child’s birth certificate and immunization records.
● Be invited for a family interview (immediate family only)
● Receive acceptance letter
● Pay Registration Fee to be admitted to class (Even if student has been accepted, he/she will not be allowed to enter class until instructional fee has been paid.)
4. Ragin Preparatory Christian Academy is not equipped to accommodate students with severe learning or physical disabilities.
5. If applying for more than one child, you must complete an application for each child.

Student Information

Student Name

First NameMiddle NameLast Name

Birth Date

MonthDayYear

Gender

Grade Applying For

Last School Attended

Any Physical Disabilities ?

Any Learning Disabilities ?

Complete the following only if transferring during school year

Please indicate reasons you wish to make this transfer now:

Family Information

Father Name

First NameLast Name

Father Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Employer and Address

Mobile Number

Area CodePhone Number

Home Phone Number

Area CodePhone Number

Work Phone

Area CodePhone Number

Father E-mail

Mother Name

First NameLast Name

Mother Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Employer and Address

Mobile Number

Area CodePhone Number

Home Phone Number

Area CodePhone Number

Work Phone Number

Area CodePhone Number

Mother E-mail

example@example.com

Emergency Release Form

In case of accident or serious illness, the school will attempt to contact a parent or guardian. If the school is unable to reach a parent or guardian, the school is hereby authorized to call the physician indicated below and to follow his instructions. If no physician is listed or if it is impossible to contact this physician, the school is authorized to make whatever arrangements seem necessary.

List medications student is allergic to

Give any medical information that may be important

Physician's Name

First NameLast Name

Phone Number

Area CodePhone Number

List two neighbors or nearby relatives who will assume temporary care of your child if you cannot be reached:

Name

First NameLast Name

Phone Number

Area CodePhone Number

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Name

First NameLast Name

Phone Number

Area CodePhone Number

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

1. I understand the primary reason for Ragin Preparatory Christian Academy is to provide my child a Christ centered quality education. I am supportive of this purpose*

Initial Only

2. I will provide the school with copies of my child’s immunization record and birth certificate within ten (10 days) of submitting this application or before the opening day of school, whichever comes first.*

Initial Only

3. I give my child permission to take part in all school activities, including P.E., sports, and field trips. It is understood that those in charge nor the school shall be held responsible in case of accident or other sickness connected with participation. If a dispute over this agreement or any claim for damages arises, the student and his parents or guardians agree to resolve this matter solely through a mutually acceptable arbitration process.*

Initial Only

Signatures

Father

Type your full name

Date

Mother

Type your full name

Date

Guardian

Type your full name

Date

Guardian

Type your full name

Date

Do not write inside this box, for office use only

Date Received

Date

Application fee paid

Date Application Send:

Date

Application Accepted

YesNoBeing Processed

Record Requested:

YesNoIncompletedReturned

My Products

USDStudent Registration Fee

Ragin Preparatory Christian Academy

Agreement