Admissions Application Form
2026-2027
Student Information
Which grade-level are you applying for?
Kindergarten
First Grade
Second Grade
Third Grade
Fourth Grade
Fifth Grade
Sixth Grade
Enrichment Program (1st-6th)
Student Name (preferred name in parenthesis)
*
First Name
Last Name
Student Gender
*
Male
Female
Student Date of Birth
*
-
Month
-
Day
Year
Date
Primary Contact Number
*
Please enter a valid phone number.
Primary Email Address
*
example@example.com
Student Primary Household Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent/Guardian's Information
Mother's Name
*
First Name
Last Name
Mother's Cell Phone Number
*
Please enter a valid phone number.
Mother's Email Address
*
example@example.com
Father's Name
*
First Name
Last Name
Father's Cell Phone Number
*
Please enter a valid phone number.
Father's Email Address
*
example@example.com
Current School
Why are you leaving current school?
Household Faith or Worldview
If you are a follower of Jesus, what does that mean to you? If you are not a follower of Jesus, what is your worldview?
*
Do you regularly attend church? If so, which church do you attend?
*
Health and Student History
Does the student have allergies of any kind? If yes, please list them below and specify the severity:
*
Does the student currently take any medications? If yes, please list all medications below:
*
Has the student ever been diagnosed with ADD, ADHD, Autism Spectrum Disorder, a speech disorder, a sensory processing disorder, a neurological disorder, or any other developmental disability/disorder? If yes, please list each of them below and provide a brief explanation of how the condition might affect his/her classroom performance:
*
Does the student have any medical, behavioral, neurological, or psychological conditions (not listed above) that would affect his/her classroom performance or require special attention? If yes, please list them below:
*
Does the student have any additional needs that the school should be aware of, or that may affect his/her classroom performance and require special attention? If yes, please describe them below:
*
Are there any additional concerns or information not covered in prior sections that may be helpful for us to be aware of?
*
Parental Agreement
I agree to take an active role in the education of my child by helping them with school work, communicating with teachers and administrators, attending conferences, and supporting the school's vision.
*
Yes
No
If questions or concerns arise, I agree to go directly and immediately to my child's teacher or individual involved in a Christian manner and according to Matthew 18:15 (“If your brother sins against you, go and tell him his fault, between you and him alone. If he listens to you, you have gained your brother.")
*
Yes
No
I agree to solve school problems and conflicts in a peaceful, confidential, and responsible manner.
*
Yes
No
I agree to treat everyone associated with the school (students, staff, parents, volunteers, etc.) with dignity and respect.
*
Yes
No
I agree to support teachers and staff with disciplinary issues and will cooperate and instruct my child at home as needed.
*
Yes
No
Statement of Faith
These statements represent the spiritual and doctinal beliefs of Light of Christ Ministries. Please review and acknowledge understanding.
We believe in the Triune God; Father, Son and Holy Spirit.
I/We Understand
We are saved by God's grace alone. We cannot save ourselves. We are by nature sinful and unclean. We praise God that He gave Jesus to pay the ultimate price for our sins so that we might live, forgiven and set free! We receive this gift of salvation through faith alone in Jesus.
I/We Understand
Our first responsibility is to have a personal, loving relationship with the Heavenly Father. Through this relationship God's Spirit empowers us to love others as Jesus has first loved us.
I/We Understand
The entire Bible is God-breathed, unchanging inspired without error. We humble ourselves before God's Word, which is the primary way the Holy Spirit convicts, enlightens and empowers followers of Jesus today.
I/We Understand
Through Jesus' death on the cross we are reconciled to God and to each other, and the Lord has given us the ministry of reconciliation. We protect the unity of this ministry by acting in love toward others, refusing to gossip, and supporting our spiritual leaders who are accountable to God.
I/We Understand
Jesus is the Way, the Truth and the Life. He is truly God and truly man. The Bible is clear: God sent His Son into the world to save the world, not condemn it. The Holy Spirit is working to bring people into a saving relationship with the Father through the Son.
I/We Understand
God alone is worthy of all our praise. We ask God to forgive us our arrogance and pride as we seek to honor God in all we think, say and do.
I/We Understand
Whoever wants to be great must be a servant to all. Jesus tells us that as we serve the hurting, often forgotten, people in this world, we are actually serving and glorifying God. We seek to serve as Jesus came to serve.
I/We Understand
We are in the world but not of the world. As our relationship with God grows, through the power of the Holy Spirit we are changed to be less like the world and more like Jesus.
I/We Understand
There are going to be areas in which we may disagree with other Christians, but these are not areas affecting salvation.
I/We Understand
We believe our faith should be visible in our daily lives, and seek to serve Him using the unique gifts God has given to each of us as we bring glory to God and love to others.
I/We Understand
The Church is the Lord's. The Church is made up of living stones, that is, followers of Jesus in every time and place. LOCCA is a very small part of God's Church. We ask the Holy Spirit's wisdom to discern the work God has for us.
I/We Understand
We affirm that God created us male and female, and these two distinct, complementary genders together reflect the image and nature of God. The Bible is clear that God's will and intention is that human sexual expression and fulfillment takes place only within the boundaries of marriage between one man and one woman. We believe that the term "marriage" has only one meaning: the uniting of one biological man and one biological woman in a single, exclusive union, as delineated in Scripture.
I/We Understand
We believe that all human life is sacred and created by God in His image. Human life of inestimable worth in all its dimensions, including pre-born babies, the aged, the physically or mentally challenged, and every other state or condition from conception through natural death. We are therefore called to defend, protect, and value all human life.
I/We Understand
Father's Signature
Mother's Signature
Date Signed
-
Month
-
Day
Year
Date
Tuition will be paid by
*
ESA
ACSTO/STO
Other
Submit
Should be Empty: