2024-2025 Waco Christian Academy Enrollment Application

Waco Christian Academy

Application Form
Additional documents for registration

Bring the following documentation to the school office.

• Original Certified Birth Certificate
• Original Social Security Card
• Current Immunization Form
Student Information
Name*

First NameLast Name
SSN*
Birth Date *

MonthDayYear
Gender*
Ethnicity*
Grade*
Have you previously applied to or attended this school?*

YesNo
If yes, what year?
Current Residence Information
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone Number*

Area CodePhone Number
Parent/Guardian Information and Resident Information(If different)
Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Email*
example@example.com
Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Emergency Contact 1
Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Email*
example@example.com
Emergency Contact 2
Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Email*
example@example.com
Physician and Medical Information
Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Preferred Hospital*
Insurance/Health Coverage (Company)
Please list any of the following: Current medications, Medication allergies, Food allergies, Chronic health concerns.

Personal Reference 1
Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Email*
example@example.com
Personal Reference 2
Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Email*
example@example.com
Academic Reference
Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Email*
example@example.com
Pastoral Reference
Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Email*
example@example.com
Church Affiliation *

Previous School
School Name*
City*
State*
Date Started*

MonthDayYear
Date Ended*

MonthDayYear
Have you ever been expelled or asked to leave any previous school?*
If yes, Explain why.*
Notes
Please inform the office of any other vital information you think they may need to know in the event of an emergency. Thank you.
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