Temple College Preparatory - Student Application Form

STUDENT INFORMATION EROLLMENT FORM

Phone: (904) 598-0078 | Fax: (904) 598-0079
Office Use Only
Grade
Teacher
Student ID #
Enrollment Date
Please Select One
FES/FES-UA/SUFS Scholarship Transfer
Enrollment Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Student's Legal Name
Date of Birth
Sex
Current Grade Level
Student Social Security #
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
Phone Number
Format: (000) 000-0000.
Race/Ethnic
Please list all sibling and their grade (if applicable)
Previous School Attended
Phone Number
Format: (000) 000-0000.
Address of School
Does your child have an IEP (Individual Educational Plan)

Parent/Guardian Information
Child primarily lives with
(Please Explain)
*Mother/Legal Guardian Name
Relationship to Child
Parent/Legal Guardian Social Security # for Scholarship Verification
Maternal Status
Home/Mailing Address
Employer
Work Phone
Format: (000) 000-0000.
Cell Phone
Format: (000) 000-0000.
*Father/Legal Guardian Name
Relationship to Child
Maternal Status
Home/Mailing Address
Employer
Work Phone
Format: (000) 000-0000.
Cell Phone
Format: (000) 000-0000.

In Case Of Emergency Please Contact The Following Person
Name
Address
Phone Number
Format: (000) 000-0000.
Authorized Persons To Pickup Student
Temple College Preparatory (TCP) understands that scheduling for working parents will sometimes inconvenience them from either bringing or picking-up their child. Please, list All Persons who are authorized to pick up your child from TCP. One copy of the persons ID/Drivers license/Authorized card must be on file in the front office in order for us to release the student. If necessary, please attach a second sheet with additional names. We advise that you stay on the side of caution and limit the number of persons who will pick-up your child. If ever there is a need for anyone else to pick-up your child, you must call TCP front office to notify us AND the person must be 18 years of age with ID. We want to keep our children safe.
All Persons Must Show Id/Drivers License/Authorized Card When Signing The Student Out
Name
Relationship
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Name
Relationship
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Name
Relationship
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.

Health Information
Is your child seen regularly by a physician?
List any health conditions such as: heart disease, diabetes, epilepsy, severe allergies, special needs, challenges or chronic conditions.
Condition/Explanation
Doctor's Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Hospital Choice
Phone Number
Format: (000) 000-0000.
Authorization for Emergency Medical Aid

I, the undersigned do hereby authorize officials of Temple College Preparatory to contact directly the persons named on this form and do authorize the named physicians to render such treatment as may be deemed necessary in an emergency for the health of the child. In the event physicians, other persons named on this form, or parents cannot be contacted, the school officials are hereby authorized to take whatever action is deemed necessary in their judgment for the health of the aforesaid child. I will assume full financial responsibility for the emergency care and/or transportation for said child and will not hold the church/school financially responsible.
Parent/Legal Guardian Name
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate

Media Consent
I grant permission to The Director and Staff of Temple College Preparatory to use me/my and my student’s photo/name/video image in photographs, videos and audiotapes for use and/or publishing in school publications, public relations, and advertisement materials, including the website.
Parent/Legal Guardian Name

First NameLast Name
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Do you consent

Required Items To Complete Student Registration

The following items are needed to complete your child’s registration:
Student Information:

✅ New Temple College Preparatory Enrollment Form
✅ Previous School Record or Report Card
✅ Copy of Birth Certificate
✅ Copy Social Security Card
✅ Updated Immunization Record (see attached sample): Health Dept. Form DH 680
✅ Physical Exam Record (see attached sample): Health Dept. Form DH 3040
✅ Step Up For Students Award Number
✅ Copy of Individual Education Plan (IEP)
Parent/Guardian Information:

✅ Parent/Guardian Picture ID and Social Security Card
✅ Parent/Guardian Driver’s License or Person authorized to pick up student at school
Per the Florida Statutes Sections 1002.42 and 1003.22 (3) TO (11) all student records are required before a student can attend public or private school. All students whose birth certificate, social security card, immunization and physical exam records are not submitted within 45 days of the first day of school will be dismissed from the school. Parents and guardians must provide records as soon as possible to comply with state regulations. If you have any questions please contact us at 598-0078 or stop by the main office.
Thank You,

Dr. James E. Parris, Jr., EdD.
Director/Principal

***For 7th Through 12th Grade Students Only***
Temple College Preparatory School needs a complete school history to request academic records for the purpose of compiling graduation requirements, including assessing and determining a curriculum track record for each student. List every school the student has attended in Middle and High School. If you cannot remember the address and phone number simply write in the name of the school, the city of the school and state where the school is located. In addition, write the year the student attended the school.
Previous Attended
Address of School

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Format: (000) 000-0000.
Fax Number
Format: (000) 000-0000.
Years Attended
Previous Attended
Address of School

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Format: (000) 000-0000.
Fax Number
Format: (000) 000-0000.
Years Attended
Previous Attended
Address of School

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Format: (000) 000-0000.
Fax Number
Format: (000) 000-0000.
Years Attended
Previous Attended
Address of School

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Format: (000) 000-0000.
Fax Number
Format: (000) 000-0000.
Years Attended
Previous Attended
Address of School

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Format: (000) 000-0000.
Fax Number
Format: (000) 000-0000.
Years Attended
Additional Information
What is your highest aspiration for your student as it relates to education?
I, the undersigned hereby confirm that all the information on this application is true and accurate.
Parent/Legal Guardian
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit year

Temple College Prep Uniform Policy
Temple College Preparatory School (TPC) is accredited by the Florida League of Christian Schools (FLOC) and the International League of Christian Schools (ILCS). Our five year accreditation gives us the right and privilege to issue high school diplomas, valid in any state and several foreign countries, to deserving students. TCP’s national accreditation has a mandatory requirement that stipulates all students must be in uniform on a daily basis. If this requirement is violated our accreditation could be revoked. Therefore, a uniform fee is assessed at a rate of $5.00 per day for any student that is not in uniform and violates our accreditation policy.

Uniforms are to be neat, clean, presentable and maintained daily. Our uniforms are as follows:

Elementary Students:

Boys -white polo shirt with navy blue pants.
Girls – white polo blouse with navy blue Skort or skirt with shorts underneath. Girls may also wear a one-piece jumper. All shirts and blouses are to have the school’s crest. Boys and girls pants, Skorts/ jumpers are not required to have the school’s initials.

Physical Education Uniform:

All elementary students shall have school approved white Tee-shirt with school’s
name and school approved navy blue gym shorts. A plain white Tee-shirt and basic navy blue shorts with no added colors, letters, initials, graphics or designs on the Tee-shirt or shorts is also permitted.

Middle and High School Students:

(7th through 12th) Boys -white Oxford shirt, navy blue pants or shorts and
black belt. Girls – white Oxford blouse with navy blue Skort or skirt with shorts underneath. Girls may also wear navy blue pants or shorts. All shirts and blouses are to have the school’s crest. Boys and girls pants and Skorts are not required to have the school’s initials.

Physical Education Uniform:

All upper grade students shall have school approved white Tee-shirt with school’s
name and school approved navy blue gym shorts. A plain white Tee-shirt and basic navy blue shorts with no added colors, letters, initials, graphics or designs on the Tee-shirt or shorts is also permitted.
Lunch Program

Lunch fee $1.00 per student per day for any or all lunch items. Lunch fee is waived for students whose guardians submits proof that student receives government benefits.
Transportation Policy

The State of Florida Department of Education (D.O.E.) spends approximately $18,000.00 per public school student. State scholarship programs only pays private schools approximately $6,500 to $7,500 per student. Therefore, private schools assess parents fees to help offset bus transportation and other school costs.

TCP makes each parent aware, when students are enrolled, that student fees are required to be paid on a timely basis. State scholarship payments mainly pay for teacher salaries, utilities and general school operations. The student fees help TCP maintain its contractual commitment with various businesses. TCP has a bus contract for morning and afternoon pick up, and drop off. Therefore, TCP assesses all students $10.00 per week for bus transportation. Families with two students will be pay a reduced rate of $8.00/student per week. Families with more than two students will pay $4.00 per student per week. If all bus students paid on time it would still only cover less than 50% of our annual transportation cost.

Note: students final reports and transcripts will be withheld if transportation fees and uniform fees are not paid by the end of the school year.
(M.S./H.S.) Student Name
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit year
Parent/Legal Guardian Name
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit year
Please verify that you are human
CRM ID
Should be Empty:

STUDENT INFORMATION EROLLMENT FORM

Office Use Only

Parent/Guardian Information

In Case Of Emergency Please Contact The Following Person

Authorized Persons To Pickup Student

All Persons Must Show Id/Drivers License/Authorized Card When Signing The Student Out

Health Information

Media Consent

Required Items To Complete Student Registration

***For 7th Through 12th Grade Students Only***

Previous Attended

Previous Attended

Previous Attended

Previous Attended

Previous Attended

Additional Information

Temple College Prep Uniform Policy

For 7th Through 12th Grade Students Only