SFJMCS ENROLLMENT APPLICATION

SMOKING FOR JESUS MINISTRY CHRISTIAN SCHOOL

ENROLLMENT APPLICATION
Family name
Parent 1*

PrefixFirst NameLast NameSuffix
Phone*
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Employment
Position
Bus. Ph#

Parent 2
Parent 2

PrefixFirst NameLast Name
Phone
Email
example@example.com
Address (if different)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Employment
Position
Bus. Ph#
Students

Student 1
Name*

First NameMiddle NameLast NameSuffix
Age*
Birthdate*

MonthDayYear
Date
Gender*
Grade Level*
Allergies (if any)
Are immunizations up-to-date?*
Upload current immunization record or waiver.*

Cancelof
Shirt size*
Shorts size

Student 2
Name

First NameMiddle NameLast NameSuffix
Age
Birthdate

MonthDayYear
Date
Gender
Grade Level
Allergies (if any)
Are immunizations up-to-date?
Upload current immunization record or waiver.

Cancelof
Shirt size
Shorts size
Note: There will be space at the bottom of the application to enroll additional students.

Medical Information
Physician*
Phone*
Insurance
Policy #

Emergency Contact
1. Name
Relation
Phone
2. Name
Relation
Phone

PAYMENT OPTIONS
Choose one:

FULL PAYMENT IN ADVANCE-Entire payment must be paid by 1st day of school for the coming school year.TEN MONTH PAYMENT PLAN- Ten payments begin on the 1st day of school and must be paid on the 1st of each month for 10 months (through May 1st). Monthly payments are due by the 1st of each month. Unpaid balances will be assessed a $50 late fee on the 5th of each month.

Withdrawal Policy
- If monthly tuition & late fee are not paid in full by the end of the month, the student will be considered withdrawn by administration unless arrangements have been made by the finance committee through the administrator.
- In the case a student is withdrawn any time after the 1st day of the school year, tuition, if paid, willbe refunded for the months not yet entered. Example: A student is withdrawn in the 1st week of December, any tuition paid for the months of January through May will be refunded. Full monthly tuition installment for the month of December will be due if not already paid. Application, Diagnostic Testing, Athletics, Registration & Book fees are all non-refundable.
- Please note that refunds, (if any), can take up to 30 business days to be processed and issued. No school records will be released to the parents/guardians until the withdrawal process has been completed, the financial account fulfilled, and any balances satisfied.
Parent 1: Signature*

Clear
Parent 2: Signature

Clear

AGREEMENT
- I, hereby, pledge to pay my financial obligations to the school on the dates due and understand that it may be necessary to withdraw my student if proper arrangements are not made on a past due account.
- I give permission for my student to take part in all school activities, including sports and school sponsored trips away from the school premises, and absolve the school from liability to me or my student because of any injury to my student at school or during any school activity.
- I agree to uphold and support the high academic standard of the school by providing a place at home for my student to study and giving my student encouragement in the completion of any homework or assignments.
- I appreciate the standards of the school and do not tolerate profanity, obscenity in word or action, dishonor to the Godhead and the Word of God, or disrespect to the personnel of the school.
- I hereby agree to support all regulations of the school in the applicant's behalf and authorize this school to employ discipline as it deems wise and expedient for the training of my student according to school policy.
- I understand that the school reserves the right to dismiss any student who fails to comply with the established regulations and discipline or whose financial obligation remains unpaid.
- I have been issued the Student Handbook, agree to participate in any Parent Orientation and training.
- I agree to fulfill my family obligation to volunteer hours as agreed upon.
- I understand the terms stated in this agreement and do agree thereto.
- I understand that, in efforts to maintain low, affordable tuition for our families, 100% participation in school fundraisers is mandatory for all families. In the case of a family's fundraiser goal not being met, the balance of that goal could be assessed to the family account.
Regional & International Student Conventions / Service Adventure

Participation in Regional & International Student Conventions and Service Adventure is essential in the educational program we offer here at SFJMCS. Therefore, student in participation is mandatory with few exceptions.

SFJMCS ACCREDITATION ACKNOWLEDGEMENT
- I am fully aware that Smoking For Jesus Ministry Christian School is not accredited or affiliated with any accreditation agency during the 2025-26 school year. Although SFJMCS holds Model Status under the educational standards of Accelerated Christian Education, ACE is not an accrediting agency and pre-high school or high school credits earned by your student(s) may or may not be recognized by any other educational institution. In the event that your student(s) need to transfer to another school, that school reserves the right to accept or refuse any credits earned at SFJMCS.
- I am aware that I do have the option of dual- enrolling my students in levels K-8 in Lighthouse Christian Academy at an additional cost to my SFJMCS tuition and fees.
- I understand that dual- enrollment for my students in levels 9-12 in Lighthouse Christian Academy is mandatory and is an additional cost to my SFJMCS tuition and fees.
Lighthouse Christian Academy (LCA) is awarded full accreditation status as a distance education provider by Middle States Association Commissions on Elementary and Secondary Schools (MSA-CESS National Council for Private School Accreditation (NCPSA), and Accreditation International (Ai Ai is a recognized member in good standing with the Council on Occupational Education (COE) and the International Council for Education. www.lcaed.com
Please enroll the my student(s) listed below in LCA for the 2023-24 school year. (Student's name/grade level)
Parent 1: Signature

Clear
Parent 2: Signature

Clear

Additional Students

(Optional)

Student 3
Name

First NameMiddle NameLast NameSuffix
Age
Birthdate

MonthDayYear
Date
Gender
Grade Level
Allergies (if any)
Are immunizations up-to-date?
Upload current immunization record or waiver.

Cancelof
Shirt size
Shorts size

Student 4
Name

First NameMiddle NameLast NameSuffix
Age
Birthdate

MonthDayYear
Date
Gender
Grade Level
Allergies (if any)
Are immunizations up-to-date?
Upload current immunization record or waiver.

Cancelof
Shirt size
Shorts size
Should be Empty:

SMOKING FOR JESUS MINISTRY CHRISTIAN SCHOOL

Students

AGREEMENT

SFJMCS ACCREDITATION ACKNOWLEDGEMENT

Additional Students