Registration

First Name	Last Name

Click the (+) to add more names

Other Data
Do you have an unpaid SDA school account? If so, please give the amount and the name of the school to which it is owed.
Has the student named above ever been dismissed from any other school because of unsatisfactory scholarship or conduct?
- Yes
- No
If yes, please explain
How did you learn about this school?
- Church
- Family/Friends
- Newspaper
- TV
- Other

Photo Release
Permission is given for a photograph or photographs of my child to be used in school or other Seventh-day Adventist publications, websites or Camp Meeting events, without any compensation.
- Yes
- No
Miscellaneous Parent/Guardian Data
Father
Name
First Middle Last
Address
Street Address Address Line 2 City State ZIP Code
Home Phone
Cell Phone
Email
Church Affiliation
Baptized?
- Yes
- No
Birthplace
Citizenship
Occupation
Company
Work Phone
Mother
Name
First Middle Last
Address
Street Address Address Line 2 City State ZIP Code
Home Phone
Cell Phone
Email
Church Affiliation
Baptized?
- Yes
- No
Birthplace
Citizenship
Occupation
Company
Work Phone
Guardian
Name
First Middle Last
Address
Street Address Address Line 2 City State ZIP Code
Home Phone
Cell Phone
Email
Church Affiliation
Baptized?
- Yes
- No
Birthplace
Citizenship
Occupation
Company
Work Phone
I have fully completed all the questions and find they are correct. I agree to the conditions herein stated. I am in harmony with the regulations and policies of the Institution, as stated in the School Handbook and as shall be announced by the Principal and Business Manager during the year. I agree to assume the financial responsibility for the student.
- Agree

Student Information