Applicant Information
Current grade or Previous grade completed Applying to grade   

Applicant's Information
First
Middle
Last
Gender
Current Age Social Security Number
Date of Birth Citizenship, if other than US
Last School Attended
Dates Attended
Please list any special education services your child has received in the last three years


Parents Information
Father’s Name
Father's Home Phone
Father's Address
Father's City
Father's State Fathers ZIP
Father's Employer Fathers Work Phone
Father's E-Mail Address

Mother’s Name
Mother’s Home Phone
Mother’s Address
Mother’s City
Mother’s State Mother’s ZIP
Mother’s Employer Mother’s Work Phone
Mother's E-Mail Address

Marital Status


If other than above, Name of applicant’s legal guardian

   

Applicant lives with
Name
Home Phone
Address
City


Other Children in Family:
Name Age   
Name Age   
Name Age   
Name Age   

Church Attended Are you a member?
Pastor's Name     Phone
How did you hear about First Assembly Christian School?  
 
By entering your name in the space provided below and clicking on "Submit Application to First Assembly" you are certifying that you understand that this application does not assure final enrollment but provides information upon which a decision is based, and that you further attest that to the best of your knowledge the information provided on this application is correct.
Signature of Parent/Guardian (Type your name into the space provided.)
First Assembly Christian School admits students of any race, color, national and ethnic origin to all the rights, privileges, programs, and activities generally accorded or made available to students of the school. It does not discriminate on the basis of race, color, national and ethnic origin in administration of its educational policies, admissions policies, scholarship and loan programs, athletic, and other school-administered programs.