Seymour Community Christian School Student Application

Seymour Community Christian School

Student Application Form
NOTE: It is understood that the school has a right to accept or reject a student , as it deems advisable.
Student Information
School Year *
eg. 2018-19
Grade applied for*
Student's Name*

First NameMiddle NameLast Name
Date of Birth *

DayMonthYear
Birthplace
Gender*
Current Address *

Street Address

Street Address Line 2

CityState / Province

Zip CodeCountry
Phone Number*
Please enter a valid phone number.
Email*
example@example.com

Previous School Information

Please list each school the student has attended starting with the most recent.
Name of School
Phone Number
Email
Grade Attended
Date Attended From

DayMonthYear
Date
Date Attended To

DayMonthYear
Date
Name of School
Phone Number
Email
Grade Attended
Date Attended From

DayMonthYear
Date
Date Attended To

DayMonthYear
Date
Name of School
Phone Number
Email
Grade Attended
Date Attended From

DayMonthYear
Date
Date Attended To

DayMonthYear
Date

Statement of Faith
We believe in the verbal inspiration of the Bible, both the old and new testaments, the Trinity of the Godhead; the creation of man by the direct act of God; the fall of man and his need for redemption; the deity, incarnation and virgin birth of our Lord and Saviour Jesus Christ; His vicarious atonement for the sins of mankind by the shedding of His blood on the cross; the resurrection of His body from the tomb; His ascension into heaven; His personal, imminent return; the deity of the Holy Spirit; justification of the believer by grace through faith; a literal devil who is our adversary; a literal heaven for the redeemed and a literal hell for the lost; the infallible rule of interpretation of scripture to be scripture itself; and the requirement of implicit obedience to the commands of Christ as the standard by which He will judge our love to Him.
Do you fully subscribe to this Statement of Faith?*

YesNo
Non-Discriminatory Policy
SCCS admits students of any race, color, national, or ethnic origin, sex, or handicap to all the rights, priveleges, programs, and activities generally accorded or made available to students at the school. It does not discriminate on the basis of race, color, national origin, sex, or handicap in administration of its educational policies, athletics, or other school administered programs.
Agreement of Co-operation:
Declaration by Parents/Guardian
1. As the parent (or guardian) of the above applicant, I agree to co-operate with SEYMOUR COMMUNITY CHRISTIAN SCHOOL in the enforcement of the disciplinary rules and regulations of the institution and to meet the terms of the agreement about expenses and business details as outlined by the school.
2. I also agree to give my permission for my child to go on field trips and school trips and will not hold the school or any person responsible in case of an accident. This includes all carpools as well as buses and vans.
3. Before a student can begin classes at SEYMOUR COMMUNITY CHRISTIAN SCHOOL, the following must be on file at the school: All application information, tuition contract, student transcripts, registration, book, and activity fees, and a complete Tennessee School Immunization Certificate.
Signature*

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Name*

First NameLast Name
Relationship to the Student*
Date*

DayMonthYear
Date
Should be Empty:

Seymour Community Christian School

Student Information

Previous School Information

Student Academic Information

Statement of Faith

Non-Discriminatory Policy

Agreement of Co-operation: