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1555 FAX: 816.279.4574 www.stjosephchristian.com
Application for Admission 2011/2012
Secondary: 5401B Gene Field Road St. Joseph, MO 64506 816.279.3760 FAX: 816.279.3836 Date Received__________________
Student’s Legal Name __________________________________ DOB ____/____/____ SS#_____-____-_____ Entry Grade at SJCS_______ Pre-K preference: AM, PM, either (Circle one)
Admission to St. Joseph Christian School is based upon a personal interview with parents (and personal interview with student 7–12), this application, student test results, and other academic/spiritual input. Due to a lack of specialized services, SJCS cannot enroll students whose special education needs cannot be met in the present program. Students and parents are expected to adhere to St. Joseph Christian School's "General Behavior Expectation" or “Student Conduct” as stated in the SJCS Student Handbook or found on the website: www.stjosephchristian.com. St. Joseph Christian School reserves the right to deny admission to any applicant. St. Joseph Christian School does not discriminate on the basis of race, color, or national or ethnic origin in the administration of its educational policies, admissions policies, sponsorship programs, athletic programs, and other school-administered programs.
Name/address of custodial parent(s):
Father Mother Mr._________________________________________ Ms./Mrs. (circle)________________________________ Address_____________________________________ Address______________________________________ City, State_____________________ Zip___________ Home phone_________________________________ Cell phone __________________________________ Email ______________________________________ City, State_______________________ Zip __________ Home phone___________________________________ Cell phone ____________________________________ Email ________________________________________
Occupation __________________________________ Occupation ___________________________________ Employer____________________________________ Employer _____________________________________ Business phone_______________________________ Business phone ________________________________ Do you attend church? ________________________ Do you attend church_________________________ How often? __________________________________ How often? ___________________________________ Church name ________________________________ Church name__________________________________
Address_____________________________________ Address _____________________________________ City, State____________________ Zip ___________ Pastor's name________________________________ Do any of the following apply? Widow/er Separated Is child by present marriage? _____________ If child is not living with his/her natural mother and father, please explain the present home situation. _________________________________________ _________________________________________ _________________________________________ _________________________________________ _________________________________________ _________________________________________
Non-custodial parent does/does not (circle) wish to receive school communications (newsletter, etc.).
City, State _______________________Zip__________ Pastor's name_________________________________ Do any of the following apply? Separated Is child by present marriage? ____________ Non-custodial parent information (if applicable): Name ________________________________________ Address ______________________________________ City, State_________________________ Zip_________ Home phone___________________________________ Cell phone____________________________________ Email ________________________________________ Occupation ___________________________________ Employer _____________________________________ Business phone ________________________________
Please list other children and other persons living with the family. Name Relationship Birthday (month, day, year)
Names of other children enrolled at St. Joseph Christian School: _________________________________ Has the student previously applied to or attended (circle one) SJCS? If yes, give year:_______ Please list schools attended during the last three years: School Address, City, State, Zip Grades
Which public school would your child have attended? ___________________________________________ Has the student ever been suspended? expelled? asked to withdraw? (circle) If yes to any, please give full particulars on a separate sheet of paper, including the principal's name and the school's name and address. Did previous school request parent conference to discuss discipline matter during the past year? _________ If so, please explain the situation on separate sheet of paper. Did previous school suggest testing for a learning concern? ______ Modify classroom expectations in anyway? ______ If so, please explain on a separate sheet of paper. Does student have any learning concerns that might limit him/her, such as: Dyslexia Yes No Hand-eye coordination Yes No ADD/ADHD Yes No Learning disability Yes No Others____________________________________________________________ If yes to any of the above, please explain on separate sheet of paper. Does the student have a physical, emotional, or mental disability that may affect his/her schooling? ____ If yes, please explain on a separate sheet of paper. Briefly describe the student's extracurricular interests and abilities: _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________
In signing this application, we give permission for our child to participate in all school activities including sports and school-sponsored trips away from the school premises (except as specifically listed below). Further, if our child becomes ill or is injured while under school supervision, we permit school authorities to take the following steps: Contact a parent of the student and follow his/her instructions. In the event neither parent can be reached, contact the student's physician and follow his instructions. If the student's physician cannot be reached, the school authorities will use their own discretion in contacting a properly licensed practicing physician and follow his instructions. We agree to relieve SJCS, its school board, and any of its employees from any liability in connection with these activities and instructions. Exceptions (if any): _____________________________________________________ In signing this application, we acknowledge the following:
SJCS STATEMENT OF FAITH
THE WORD OF GOD The Word of God, in both the Old and New Testaments, is inerrant as originally given. It is inspired by God, and it is the complete revelation of Himself to man. It is the consistent, only word of God (2 Timothy 3:16–17; 2 Peter 1:20–21; Revelation 22:18– 19). GOD There is one and only one living God. He is infinitely perfect, existing eternally in three persons: Father, Son, and Holy Spirit (1 Timothy 1:17; Matthew 28:19; Mark 1:10–11). JESUS CHRIST Jesus Christ is the eternal, only Son of God, who was conceived by the Holy Spirit and born of a virgin birth. Jesus is truly God and truly man. He died on the cross as a substitutionary sacrifice. All who believe in Jesus by faith are justified on the basis of His shed blood on the cross. Jesus died and physically rose again after three days and ascended into heaven where He is exalted at the right hand of the Father. He will physically return to judge the world and establish His kingdom (John 1:1–3; Isaiah 7:14; Matthew 1:18; 1 Corinthians 15:3–4; 1 Timothy 1:15–17). THE HOLY SPIRIT The Holy Spirit is sent to indwell, guide, teach, and empower believers. The Holy Spirit convicts the world of sin, righteousness, and judgment (Acts 2:38; Ephesians 1:13–14; 1 Corinthians 6:19; John 16:7–8). MANKIND Mankind was originally created without sin and in the image and likeness of God. He sinned through disobedience and incurred physical and spiritual death. The eternal soul of a man is given at conception, and as eternal, will experience either eternal life in heaven or eternal death in hell, based upon one's relationship with Christ (Genesis 1:26–27; Psalm 139:13–16; Jeremiah 1:5; Romans 3:23; Revelation 20:10–15; 1 John 5:11–12). SALVATION Salvation has been provided through the death and resurrection of Jesus Christ for all who by faith believe in Him as Savior. All who personally accept Him as Savior are born again and receive the Holy Spirit, the gift of eternal life, and become children of God (John 1:14–18; 1 Corinthians 15:3–4; Ephesians 2:8–9; 1 John 5:9–13; John 1:12).
Our commitment to the statement of faith of St. Joseph Christian School. Our commitment to the "General Behavior Expectation" or “Student Conduct” as stated in the ParentStudent Handbook (on the website at: www.stjosephchristian.com) and to the policies and procedures of SJCS. Our commitment to volunteer and log a minimum of twenty hours per year at SJCS. Our commitment to follow the “Matthew 18 Principle.” If our child(ren) should become involved in any trouble, or we disagree with any policy set by the school, we will not complain to any other party and, in the spirit of meekness, will register only necessary concerns with the teacher or leaders involved (Matthew 18:15–17). All final grades and credits will be held until accounts are paid in full. Records will not be transferred to another school if money is due St. Joseph Christian. Our commitment to God's mandate to train our child(ren) after the example of Christ and support the school and church in pursuit of that goal. The administration will be responsible for placing our student(s) in the proper grade level or class section.
Signature of Concurrence (Father) ____________________________________________Date______________ Signature of Concurrence (Mother) ____________________________________________Date______________
St. Joseph Christian School is fully accredited grades K–12 by the Association of Christian Schools International (ACSI) and North Central Association Commission on Accreditation and School Improvement Association (NCA CASI).
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