Student Application

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This field is for validation purposes and should be left unchanged.

Student Information

Student Name(Required)

First Middle Last Suffix

Gender(Required)

Male

Female

Date of Birth(Required)

Please enter your students Date of Birth

SSN

Enter your student’s Social Security Number

Student Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Place of Birth (City, State)(Required)

Example: Dallas, TX

First Language(Required)

Example: Spanish

Grade Entering(Required)

Select the grade you are applying for your student.

Church Membership

If applicable

Date of Baptism (if applicable)

Enter the date your student has been baptized.

Family Information

Please fill out the following in regards to Parent Information.

Parent/Guardian 1 Name(Required)

First Last

Relationship to Student(Required)

Phone(Required)

Church Membership(Required)

Example: Burleson SDA, Burleson Spanish SDA, etc, or None

Email(Required)

Enter Email Confirm Email

Address (if different from student)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Parent/Guardian 2 Name(Required)

First Last

Relationship to Student(Required)

Phone(Required)

Church Membership(Required)

Example: Burleson SDA, Burleson Spanish SDA, etc, or None

Email(Required)

Enter Email Confirm Email

Address (if different from student)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Student Lives With(Required)

Parent 1

Parent 2

Both

Other

Bills Sent to(Required)

Parent 1

Parent 2

Both

Please select who will be responsible financially.

Student History

Last School Attended(Required)

Please list last school enrolled in, homeschooled, or none

Withdraw Date

Please list date your student withdrew from previous school.

Last School Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Has the applicant ever been suspended/expelled?(Required)

Yes

No

If yes, please explain reason:

Has the applicant ever received help for a learning difficulty?(Required)

Yes

No

If yes, please explain reason:

Has the applicant ever been diagnosed with any Learning Disability?(Required)

Yes

No

Currently being evaluated

Uploaded related testing data or reports:

Drop files here or

Max. file size: 150 MB.

Please make sure these are scanned, not a photo of the document. Or bring in person to get a photocopy.

Records

Please submit the following records: Birth Certificate, Updated Immunization records/waiver, and transcripts (if applicable). If you are a returning student, possibly only need updated shot records.

Birth Certificate

Max. file size: 150 MB.

Needed for NEW Students.

Immunization Records

Drop files here or

Max. file size: 150 MB.

Most recent Immunization Records, see additional forms for waiver and needed records. Please make sure these are scanned, not a photo of the document. Or bring in person to get a photocopy.

Transcripts

Drop files here or

Max. file size: 150 MB.

NEW Students only – submit records from previous school: Attendance, grades, discipline, learning disability, etc. Please make sure these are scanned, not a photo of the document. Or bring in person to get a photocopy.

Parent/Guardian Name Agreement(Required)

First Last