Step 1 of 3 0% Grade EnteringDate of Application Student InformationStudent Name First Middle Last Student Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home PhoneStudent's Date Of Birth Birth PlaceAgeSexMaleFemaleCitizenshipLanguage Spoken At HomeName of person to contact in emergency if parent/guardian is unavailable First Last Emergency Contact PhoneChurch AffiliationWith whom does the child reside?Baptized?YesNoDate Baptized Individuals that above student has permission to ride withFirst NameLast Name Click the (+) to add more namesPlace of Church MembershipName Of Student's SiblingsNameAgeSex Click the (+) to add more names Other DataDo 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?YesNoIf yes, please explain How did you learn about this school? Church Family/Friends Newspaper TV Other Photo ReleasePermission 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.YesNoMiscellaneous Parent/Guardian DataFatherName First Middle Last Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home PhoneCell PhoneEmail Church AffiliationBaptized?YesNoBirthplaceCitizenshipOccupationCompanyWork PhoneMotherName First Middle Last Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home PhoneCell PhoneEmail Church AffiliationBaptized?YesNoBirthplaceCitizenshipOccupationCompanyWork PhoneGuardianName First Middle Last Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home PhoneCell PhoneEmail Church AffiliationBaptized?YesNoBirthplaceCitizenshipOccupationCompanyWork PhoneI 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
