Christian School

Application for Admission

Student Information

One application per student

Attach a copy of the student's transcript for Grades 10-12, report card for Grades1-9.

Student Date of Birth Age __ __ __

Gender ___________ Applying for grade _____________For term beginning

1. Please list schools previously attended:

School Address/Zip Dates Grades Completed

2. Has the student ever been suspended? expelled? , or asked to withdraw?

If so, please give full particulars on a separate sheet of paper, including the principal's name and the address of the school.

3. Has the student ever failed a grade? Yes No If so, state grade and date

4. Why is your student transferring from his/her present school?

5. Has your child, to your knowledge, used any type of drugs, alcohol, tobacco, or has he/she ever been in any type of trouble with the law?

6. If you have further information which may assist in the guidance of your child at MVCS such as pertinent medical or other data the school should be aware of, please indicate below.

7. Does the student have any type of learning disability? Yes No

Has the student been in any special education programs? Yes No

If yes, please describe the program:

8. Does the student attend church regularly? Yes No

Does the student attend church activities regularly? Yes No

Does the student attend Sunday school? Yes No

Does the student attend Youth Group? Yes No

Has the student expressed that he/she has a saving relationship with Jesus Christ? Yes No

9. Why do you want your child to enter Mount Vernon Christian?

10. Is it your intention to have your child graduate from MVC? If not, please explain.

11. Describe the student's interests and God given abilities:

12. Is there any medical reason the applicant cannot participate in the physical education program?

Yes No If "yes," please explain

DATE:

PARENT’S SIGNATURE: