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820 (360) 424-9157 (360) 424-9256 FAX |
Application
for Admission
Parent
Questionnaire
All
information must be provided for this application to be considered.
Only one per family is required.
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1. Father’s Name: |
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Father’s Address: |
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STREET |
CITY |
STATE |
ZIP |
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Father’s Telephone: |
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HOME |
BUSINESS |
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Father’s Occupation: |
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COMPANY |
POSITION |
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Business Address: |
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STREET |
CITY |
STATE |
ZIP |
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2. Mother’s Name |
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Mother’s Address: |
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STREET |
CITY |
STATE |
ZIP |
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Mother’s Telephone: |
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HOME |
BUSINESS |
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Mother’s Occupation: |
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COMPANY |
POSITION |
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Business Address: |
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STREET |
CITY |
STATE |
ZIP |
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3. Have you ever
applied for admission to MVCS for another student: |
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YES |
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NO |
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4.
If there are other children in your family, please
complete the following: |
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Name: |
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Age: |
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School: |
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Name: |
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Age: |
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School: |
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Name: |
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Age: |
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School: |
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5.
What is the parents’ marital relationship? |
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Parents are: |
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married and members of same household |
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separated |
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divorced |
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one parent deceased |
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student living with natural parent and step parent |
6. Is the student
living with at least one parent? |
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YES |
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NO |
If
“no,” with whom is the student living (grandparent, guardian, etc.)
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7. |
If
parents are divorced or separated, who has legal custody of the student? (Name of parent or legal guardian) |
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8.
Name the person responsible for payment of school
fees: |
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NAME |
ADDRESS, STATE, ZIP |
PHONE |
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9. According to MVCS admission policy, at least one parent must
be committed to Jesus Christ as his/her Savior. |
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10. What is the
father’s relationship to Jesus Christ? |
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11. What is the
mother’s relationship to Jesus Christ? |
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12.
Are you personally in agreement with and committed
to the basic doctrines of historic Christianity as summarized below? |
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Husband: |
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Yes |
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No |
Wife: |
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Yes |
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No |
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Legal
Guardian: |
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Yes |
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No |
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a.
God is a Triune God—Father, Son, and Holy Spirit |
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b.
The Bible is God’s infallible and authoritative
Word to man. It is the only standard
by which faith and practice are to be measured. |
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c.
The chief objective of man is to glorify God and
enjoy Him forever. |
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d.
Man is created in the image of God. Through his relationship to Adam, man is a
sinner by nature. He is thus alienated from God, his neighbor, and the world. |
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e.
Jesus Christ is the only Savior of sinners, the
only way to the Father. He died as a
substitute for sinners and was raised
from the dead so that they might be reconciled to God. |
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f.
Eternal life is a free gift that is received
through faith in Jesus alone. Eternal
life is neither deserved by anyone, nor can
it be earned by good deeds. |
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13.
On a separate sheet of paper, share the ways in
which the Christian faith forms and directs your family’s life. |
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14. Have you read the Mission Statement of Mount Vernon Christian
School, and do you desire this education for your |
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YES |
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NO |
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15. Are you willing for your student to receive training in the
doctrines of historic Christianity expressed in (a) through (f) above and will you support the school in
its endeavors to encourage and guide your child(ren) in applying these doctrines to life? |
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YES |
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NO |
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16.
Of which church or parish is your family? |
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CHURCH NAME / DENOMINATION |
ADDRESS |
PASTOR’S NAME |
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17.
How did you become aware of |
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Current MVCS Family: |
(name) |
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Former MVCS Family: |
(name) |
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MVCS Newsletter or
Wednesday Whatnot |
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Church: |
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Newspaper or other media: |
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Other |
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18.
Would you like us to send information about MVCS to
a family member or friend? |
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NAME |
ADDRESS, CITY, STATE, ZIP CODE |
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DATE: |
APPLICANT
SIGNATURE: |