Student Application

Student Application

This form is to be filled out by the parent/guardian and applicant. Please allow approximately 30 minutes for the completion of this detailed form.
Please Note: This form requires much knowledge and information pertaining to the applicant. It is highly recomended that you review this form and gather all neccessary information prior to the start of filling out this form.
Applicant Name (Student)*

First NameMiddle NameLast Name
Applicant is Usually Called:
Example: First name, nickname, shortened name, etc.
Grade to Enter*
Year/Semester to Enter*

1st2nd
Date of Birth*

MonthDayYear
Date
Birthplace:*
Social Security Number*
Gender*

MaleFemale
Schools Attended:
School Name 1*

School Name

Street Address

CityState / Province

Postal / Zip Code
Attendance Dates at School 1:
From: - To:
Grades Completed at School 1
School Name 2

School Name

Street Address

CityState / Province

Postal / Zip Code
Attendance Dates at School 2:
From: - To:
Grades Completed at School 2
School Name 3

School Name

Street Address

CityState / Province

Postal / Zip Code
Attendance Dates at School3 :
From: - To:
Grades Completed at School 3
School Background

Select the grade in each subject which corresponds wo the last grading period.
English*

ABCDF
Mathematics*

ABCDF
Science*

ABCDF
History*

ABCDF
Activities of Interest*
List musical involvement, sports, clubs, hobbies, and interests.
Impairments
List any physical impairments, learning disabilities, or psychological disorders.
Allergies and Health
List any allergies or other health info we should be aware of.
Has the applicant ever been suspended or expelled from any school?*

NoYes (please explain in box below)
Student Applicant Section

The following questions are to be answered as completely and accurately BY THE STUDENT applicant.
Have you accepted Jesus Christ as your personal Savior?*

YesNoUnsure
Personal Testimony (if applicable)
Please briefly describe your salvation and personal relationship with the Lord.
Please read the following Scripture passages if you have never received Jesus Christ as your personal Savior.

What must I do to be saved?

Admit that you are a sinner. The Bible says, “For all have sinned and come short of the glory of God.” Romans 3:23
Sin must be paid for. The Bible says, “For the wages of sin is death; but the gift of God is eternal life through Jesus Christ our Lord.” Romans 6:23
Christ paid for our sins. “For God so loved the world that he gave his only begotten Son, that whosoever believeth in him should not perish, but have everlasting life.” John 3:16
You must repent of your sins. “Except ye repent, ye shall all likewise perish.” Luke 13:3
Ask Jesus Christ to save you. “For whosoever shall call upon the name of the Lord shall be saved.” Romans 10:13; “Believe on the Lord Jesus Christ, and thou shalt be saved.” Acts 16:31
Confess Jesus before men. “If thou shalt confess with thy mouth the Lord Jesus and shalt believe in thine heart that God hath raised him from the dead, thou shalt be saved. For with the heart man believeth unto righteousness; and with the mouth confession is made unto salvation.” Romans 10:9-10
Why do you wish to attend Faith Christian Academy?
Please read statement carefuly:

At Faith Christian Academy we believe that the principles found in the Bible should govern our behavior. The Bible teaches that we should glorify God in all that we do, and positively influence others and ourselves. In addition, it instructs us of our responsibility to maintain a good testimony before unbelievers.

In order to promote an atmosphere which honors the Lord, we have instituted certain rules which govern behavior. Some of these reflect our Biblical convictions. Others reflect our desire to establish standards which avoid all appearance of evil and enable us to maintain testimonies which are above reproach. Still others are included in order that we may do all things decently and in order.

Specifically, students must incorporate habits in their lives which stimulate spiritual growth, including regular church attendance in a doctrinally sound church, reading of the Bible, and consistent prayer. Students are not permitted to use alcoholic beverages, non-medical drugs, or tobacco. Immorality, including pre-marital sex and homosexuality, are forbidden by the Word of God and grounds for dismissal from FCA. Students must separate from worldly influences, such as explicit music, movies containing ungodly philosophy and content, pornographic literature, and behavior and dress associated with the world’s philosophy. Bad attitudes are not tolerated, including attitudes of distrust, dishonestly, selfishness, damaging criticism, disrespect, unethical conduct, and irreverence. Students are expected to maintain this kind of behavior both on and off campus.

Those who consistently disregard these guidelines may lose their privilege of re-enrollment or may be dismissed from school.
Do you agree to abide by the behavioral guidelines described above and in the Student Handbook*

YesNo (please explain your disagreements in the box below)
Applicant's Signature (student)

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Family Information:

To be filled out by applicant's parent or guardian.
Father's Name*

PrefixFirst NameLast Name
Father's Marital Status:*
Father's Email:*
example@example.com
Father's Social Security Number:
Father's Home Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Father's Home Phone Number:
Please enter a valid phone number.
Father's Mobile Phone Number:
Please enter a valid phone number.
May we publish father's phone number in the school directory?*

YesNo
Father's Occupation:*
Father's Employer:*
Father's Employment Work Number:*
Please enter a valid phone number.
Mother's Name*

PrefixFirst NameLast Name
Mother's Marital Status:*
Mother's Email:*
example@example.com
Mother's Social Security Number:
Mother's Home Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mother's Home Phone Number:*
Please enter a valid phone number.
Mother's Mobile Phone Number:*
Please enter a valid phone number.
May we publish mother's phone number in the school directory?*

YesNo
Mother's Occupation:*
Mother's Employer:*
Mother's Employment Work Number:*
Please enter a valid phone number.
Paternal Grandparents' Names:*
Paternal Grandparents' Phone Number:*
Please enter a valid phone number.
Paternal Grandparents' Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Maternal Grandparents' Names:*
Maternal Grandparents' Phone Number:*
Please enter a valid phone number.
Maternal Grandparents' Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please list the names, ages, and grades of other children living at home.
Church Information
Church Attending:
Membership Status:
Church Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Church Phone Number
Please enter a valid phone number.
Pastor's Name
Please describe your church attendance:*

All services regularly (1-2 per week)Some services regularly (1-3 per month)Attend services occasionallyRarely attend churchDo not attend church
Emergency Info
Emergency Contact*

First NameLast Name
Emergency Contact Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact Phone Number*
Please enter a valid phone number.
Your Relationship to Emergency Contact*
Family Doctor*
Family Doctor Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Family Doctor Phone Number*
Please enter a valid phone number.
Why do you wish to enroll your child in Faith Christian Academy?*
Tuition Schedule and options & directions for payment ($6,800 for the year): O Monthly Payments, O Quarterly Payments, O Tuition paid in full

Registration Fee of $200 is due when your application is turned in.

$30 fee as the result of bad checks to cover our admin costs.

$35 fee for tuition payments that are received (10) days after the due date (payments are due on the 15th of each month).

*Payments for the monthly payment schedule are due the 15th of each month.

*Payments for the quarterly payments are to be paid the 15th of each quarter.

The following fees will be assessed:

Athletic fees: All participating students will pay $100.00 annually (this money helps pay for officials presiding over athletic events, fees associated with each sporting event, etc.).

Please mail or hand deliver check to:

Faith Christian Academy
237 Arnoldsburg Rd.
Spencer, WV 25276
I have read the Faith Christian Academy Behavioral Guidelines and, by voluntarilysigning below, I express my agreement with their content and spirit.
Father's Signature

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Mother's Signature

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Should be Empty:

Student Application

Schools Attended:

School Background

Student Applicant Section

Family Information:

Church Information

Emergency Info