Wallace Ridge Christian Academy

Wallace Ridge Christian Academy
Application for Admission
14565 LA-124
Jonesville, LA 71343
Complete one form per student.
Mail or deliver completed form to above address.
Date submitted:

MonthDayYear
Date
Applicant information (to be completed by parent/legal guardian only, with official proof of guardianship and government issued identification)
CHILD'S LEGAL NAME:
CHILD'S LEGAL NAME:

First NameMiddle NameLast Name
DOB

MonthDayYear
Date
Home Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Apt. #:
City:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home:
Format: (000) 000-0000.
Cell:
Format: (000) 000-0000.
GRADE ENTERING IN 2026-2027:
K, 1, 2, or 3
Gender:
Please note: All graded assignments are tentative until all former school records have been received.
Last Pre-School/Elementary School Attended:
School Address:
School District:
City:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Has your child attended any other schools? YES or NO - Which if yes?
Please sign in the space provided below.
I,
give WRCA permission to contact my child's
previous school.
Last grade completed:
How did you learn about WRCA?

Has the student been in advanced classes?
If yes, what grade/curriculum:
Does your student have any academic challenges?
If yes, what area:
Has additional special testing or tutoring been indicted at any point in school?
If yes, what area:
Has the student ever been dismissed from school for any reason?
If yes, explain and include the name of the school and principal:

EMERGENCY CONTACTS
(other than parents/guardians)

REQUIRED
Please note that by listing individuals below, you are authorizing them to provide transportation for your child.
1st person to contact:
Name

First NameLast Name
Home Address:
Cell:
Format: (000) 000-0000.
Work Address:
Work:
Format: (000) 000-0000.
2nd person to contact:
Name

First NameLast Name
Home Address:
Cell:
Format: (000) 000-0000.
Work Address:
Work:
Format: (000) 000-0000.
Individuals, other than parents, to whom the school is authorized to release the child to and provide transportation for the child:
Name:
Drivers License Number:
Name:
Drivers License Number:

HEALTH INFORMATION
All students must submit an immunization record or a waiver of immunization before being admitted to WRCA.
Allergies (Please check all that apply):
Allergens:
Reactions:
Allergens:
Reactions:
Allergens:
Reactions:
Are any of these allergies severe or life-threatening?
If yes, please provide instructions:
Height:
Weight:
Hair Color:
Eye Color:
Distinguishing Marks:
Special Dietary Needs:
Medications/dosage that will be administered regularly at the school:
Does your child have any medical or physical needs:

SPECIAL EDUCATION
Did your child receive special education services at a previous school?
If yes, please provide what services were received:

As applications are received, the date stamped in the “For Office Use Only” box will determine the official date and time received, not the date provided by the parent/guardian. If the number of applicants does not exceed the enrollment limit, students will be enrolled in Wallace RidgeChristian Academy (pending Enrollment Committee review of applications), and parents will receive written notification of acceptance. Parents will also be notified if their application is rejected for any reason.In cases where there are more applicants than available openings, students who are not accepted will automatically be placed on a waiting list and contacted if an opening becomes available.Preference is given to siblings of students currently enrolled in the academy. Preference is also given to members of Wallace Ridge Pentecostal Church when openings are available.Applications received after open enrollment will be accepted on a first-come, first-served basis for any remaining openings (pending Enrollment Committee review) or placed on a waiting list if no openings remain. It is the parent/guardian’s responsibility to notify the school of any address and/or phone number changes. Each application is valid for one year.Wallace Ridge Christian Academy is a private religious school and admits students of any race, color, gender (male or female), ancestry, national origin, or ethnic origin to all rights, privileges, programs, and activities generally accorded or made available to students at the school. WallaceRidge Christian Academy does not and shall not discriminate on the basis of race, color, gender(male or female), ancestry, national origin, or ethnic origin. Grade placements are tentative pending verification of the final report card for students in grades 1–12. By signing below, I certify that all information on this student application is true to the best of my knowledge.
IMPORTANT

Once your child has been accepted, you will receive a registration packet to complete. It is very important that all documents in the registration packet are completed and returned to the academy promptly. Your child’s enrollment will not be considered complete until ALL required registration documents have been submitted.

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Wallace Ridge Christian Academy

Application for Admission

CHILD'S LEGAL NAME:

FATHER/GUARDIAN'S INFORMATION:

MOTHER/GUARDIAN'S INFORMATION:

SCHOOL HISTORY

EMERGENCY CONTACTS

1st person to contact:

2nd person to contact:

HEALTH INFORMATION

Allergies (Please check all that apply):

SPECIAL EDUCATION

IMPORTANT

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