Daniel Initiative Application JotForm

The Daniel Initiative Application

For K-8th Grade
Child's Information:
Full Name
Gender
Birth Date

MonthDayYear
Grade for 2025-2026 School Year
Child's Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Has your child made Jesus Lord of his/her life?
If yes, what year did they make Jesus Lord of their life?
Has your child been baptized?
If yes, what year were they baptized?
School History
Name of school child last attended
Are you able to provide a copy of your child's previous year's report card?
Are you able to provide a copy of your students' transcripts?
What grade level is your child currently performing at in the following:
Math Grade Level
Reading Grade Level
Writing Grade Level
Briefly describe your student's previous year of schooling:
Does your child thrive in a traditional school setting?
Please explain the answer above:
How does your child best learn?
Does your child have any learning disabilities/difficulties?
If yes, please explain:
Does your child have any behavioral challenges?
If yes, please explain:
Does your child have any allergies or take any medications?
If yes, please list and explain:
Will you be registering any additional children?
If so, how many?
Second Child's Information:
Second Child's Full Name
Gender
Birth Date

MonthDayYear
Grade for 2024-2025 School Year
Child's Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Has your child made Jesus Lord of his/her life?
If yes, what year did they make Jesus Lord of their life?
Has your child been baptized?
If yes, what year were they baptized?
Second Child's School History
Name of school 2nd child last attended
Are you able to provide a copy of your child's previous year's report card?
Are you able to provide a copy of your students' transcripts?
What grade level is your child currently performing at in the following:
Math Grade Level
Reading Grade Level
Writing Grade Level
Briefly describe your student's previous year of schooling:
Does your child thrive in a traditional school setting?
Please explain the answer above:
How does your child best learn?
Does your child have any learning disabilities/difficulties?
If yes, please explain:
Does your child have any behavioral challenges?
If yes, please explain:
Does your child have any allergies or take any medications?
If yes, please list and explain:
Third Child's Information:
Third Child's Full Name
Gender
Birth Date

MonthDayYear
Grade for 2024-2025 School Year
Child's Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Has your child made Jesus Lord of his/her life?
If yes, what year did they make Jesus Lord of their life?
Has your child been baptized?
If yes, what year were they baptized?
Third Child's School History
Name of school 3rd child last attended
Are you able to provide a copy of your child's previous year's report card?
Are you able to provide a copy of your students' transcripts?
What grade level is your child currently performing at in the following:
Math Grade Level
Reading Grade Level
Writing Grade Level
Briefly describe your student's previous year of schooling:
Does your child thrive in a traditional school setting?
Please explain the answer above:
How does your child best learn?
Does your child have any learning disabilities/difficulties?
If yes, please explain:
Does your child have any behavioral challenges?
If yes, please explain:
Does your child have any allergies or take any medications?
If yes, please list and explain:
Fourth Child's Information:
Fourth Child's Full Name
Gender
Birth Date

MonthDayYear
Grade for 2024-2025 School Year
Child's Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Has your child made Jesus Lord of his/her life?
If yes, what year did they make Jesus Lord of their life?
Has your child been baptized?
If yes, what year were they baptized?
Fourth Child's School History
Name of school 4th child last attended
Are you able to provide a copy of your child's previous year's report card?
Are you able to provide a copy of your students' transcripts?
What grade level is your child currently performing at in the following:
Math Grade Level
Reading Grade Level
Writing Grade Level
Briefly describe your student's previous year of schooling:
Does your child thrive in a traditional school setting?
Please explain the answer above:
How does your child best learn?
Does your child have any learning disabilities/difficulties?
If yes, please explain:
Does your child have any behavioral challenges?
If yes, please explain:
Does your child have any allergies or take any medications?
If yes, please list and explain:
Fifth Child's Information:
Fifth Child's Full Name
Gender
Birth Date

MonthDayYear
Grade for 2024-2025 School Year
Child's Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Has your child made Jesus Lord of his/her life?
If yes, what year did they make Jesus Lord of their life?
Has your child been baptized?
If yes, what year were they baptized?
Fifth Child's School History
Name of school 5th child last attended
Are you able to provide a copy of your child's previous year's report card?
Are you able to provide a copy of your students' transcripts?
What grade level is your child currently performing at in the following:
Math Grade Level
Reading Grade Level
Writing Grade Level
Briefly describe your student's previous year of schooling:
Does your child thrive in a traditional school setting?
Please explain the answer above:
How does your child best learn?
Does your child have any learning disabilities/difficulties?
If yes, please explain:
Does your child have any behavioral challenges?
If yes, please explain:
Does your child have any allergies or take any medications?
If yes, please list and explain:

Parent/Guardian Information
Are you a parent or a guardian?
Father/Guardian Name

First NameLast Name
Father/Guardian Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Father/Guardian Cell
Please enter a valid phone number.Format: (000) 000-0000.
Father/Guardian Email
example@example.com
Mother/Guardian Name

First NameLast Name
Mother/Guardian Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mother/Guardian Cell
Please enter a valid phone number.Format: (000) 000-0000.
Mother/Guardian Email
example@example.com
***If there are any pending parent/guardian custody decisions, please request our pending form to be completed and submit a copy of the most recent court documents for the safety and well-being of your child and our volunteers.

You can upload court documents in the space above.
Cancelof

Emergency Contact Information
Name

First NameLast Name
Relationship to Child
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Does this person have your permission to pick up your child from activities?
Please add a second emergency contact below:
Name

First NameLast Name
Relationship to Child
Phone
Format: (000) 000-0000.
Does this person have your permission to pick up your child from activities?

Church Information

These are your parent/guardian answers
Church Name
Church Address

Address

Street Address Line 2

CityState / Province

Zip Code
Senior Pastor
Recommending Pastor
How often do you attend?
What classes have you taken in your church? (Father/Guardian answer)
What classes have you taken in your church? (Mother/Guardian answer)
What area(s) are you involved in your church? (Father/Guardian answer)
What area(s) are you involved in your church? (Mother/Guardian answer)
Tell us about your salvation experience? (Father/Guardian answer)
Tell us about your salvation experience? (Mother/Guardian answer)

More Information & Agreement
How did you hear about The Daniel Initiative?
Why do you think The Daniel Initiative would be a good fit for your child or children?
Please read the Parent/Guardian Partnership Requirements for the Daniel Initiative below:

Fill out school affidavit with School Board in August 2024
Oversee child’s completion of assignments/projects
Meet with leader quarterly to review child’s progress
Complete two personal growth workshops per year (finances, marriage, parenting…)
Attend 3 parent/guardian gatherings per year
Commit to fulfill one of many volunteer roles
Parents/Guardian's Signature
Parents/Guardian's Signature
Should be Empty:

Child's Information:

School History

Second Child's Information:

Second Child's School History

Third Child's Information:

Third Child's School History

Fourth Child's Information:

Fourth Child's School History

Fifth Child's Information:

Fifth Child's School History

Parent/Guardian Information

Emergency Contact Information

Church Information

More Information & Agreement