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					                                                                                        Faith Family Kids, Inc.
                                                                                                 dba
                                                                             FAITH FAMILY ACADEMIES
                                        300 West Kiest Blvd., Dallas Texas 75224 - ph. 214-375-7682 – fax 214 –375-7681
                                       701 Ovilla Road, Waxahachie, Texas 75167 – ph. 972-937-3704 – fax 972-937-5806


                                                               Application for Admission (High School)
  PLEASE ANSWER ALL QUESTIONS BELOW AND SIGN AT THE BOTTOM
Student’s Last Name                                              First Name                               Middle Name                      Generation (Jr. I, II, III)       Social Security #



 Date of Birth           Age as of Sept 1, 2012   Grade          Home Phone                                Other Phone #’s



With whom does child reside?



Street Address                                                                                          Mailing Address (If different)



City                               State                               Zip                              City                                  State                              Zip



Father’s Name                                                          Mother’s name                                                          Name of Emergency Contact Person



Place of Employment                    Business Phone                  Place of Employment                      Business Phone                Phone #



Name of Local School Campus/District student would attend if not attending any Charter School or private school     Name of last school attended? When?




  1. If your child has documented history, in reference to TEC Chapter 37, Subchapter A, has your child ever been expelled, dismissed, suspended
  or refused admission to another public, private or charter school? Yes__ No__ Explain: ____________________________________________

  2. If your child has documented history, in reference to TEC Chapter 37, Subchapter A, has child ever been assigned to an alternative program?
  Yes____ or No ____ Explain: __________________________________________________________________

  3. Does your child have any documented history of a Criminal offense?
  Explain: __________________________________________________________________

  4. If your child has documented history of a criminal offense has your child ever had disciplinary difficulties as defined by TEC Chapter 37, Subchapter A?
  Yes____ or No ____
  Explain: __________________________________________________________________

  5. Has your child ever applied or been enrolled in Faith Family Academy? Yes ________ No_______
  If so, when? ______________________________________________________________________

By my signature, I certify that the foregoing information is correct.
                                           __________________________________________________________Date_____________
                                           Parent or Guardian Signature

  The following person(s) is/are allowed to pick up my child:

  Name                                                                          Telephone Number                                                            TX DL# or ID#

  _   ________________________________                                        ________________________________                                           _________________________

  _   ________________________________                                        ________________________________                                           _________________________

  _   ________________________________                                        ________________________________                                           _________________________


   Disclosure Statements:
   It is the policy of Faith Family Academy Charter School to comply with non-discrimination provisions of all federal and state laws. FFA admits students without regard to race, religion, color,
   gender, age, national origin, ethnicity, disability, academic, artistic, athletic ability, marital status, political belief, limited English proficiency or the district the child would otherwise attend.
   FFA will deny admission to students with documented histories of a criminal offense, juvenile court adjudication, or discipline problems under TEC Chapter 37, Subchapter A. If anyone
   believes that they have been discriminated against, they should write to the Secretary of Education, Washington D.C. 20250.
   Child Find - a free appropriate public education (FAPE) is provided to all individuals with disabilities, ages 4-21, who qualify for special education services. With the assistance of the Texas
   Education Agency, ESCs, and the Early Childhood Intervention (ECI) program, LEAs must ensure that early intervention services are made available for those children, ages 0-3, with an
   identified need.

                                                                                                                                                                                                          1
                                                                                       Faith Family Kids, Inc.
                                                                                               dba
                                                                          FAITH FAMILY ACADEMIES
                                      300 West Kiest Blvd. -- Dallas Texas 75224 – ph. 214-375-7682 – fax 214-375-7681
                                      701 Ovilla Road, Waxahachie, Texas 75167 – ph. 972-937-3704 – fax 972-937-5806


                                                 2012-2013 INFORMATION / CHECK LIST-WORKSHEET
Complete                             REQUIREMENTS * ALL STUDENTS
               Student Enrollment Application – COMPLETED IN FULL
                    Parent Agreement – Enrollment Information – Medical Form
                    Pick up List – Home Language Survey – Telecomputing Network Use Agreement – etc.

               Certified Birth Certificate – not hospital issued (bring original to be copied and returned)

               Complete Shot Records (bring original to be copied and returned)

               Social Security Card (bring original to be copied and returned)

               Most recent Report Card/Transcript

               Withdrawal Form from school if student is transferring during school semesters

               “YEAR END” report card for previous year (2011-2012)/ Summer School if applicable

               Copy of IEP if student is in Special Education

               Utility Bill showing current address of residence

               If your child drives to school, a copy of current insurance, driver’s license, license plate, make, model and color of vehicle will be
               required to be on file with FFA campus security
                                                                                                                                                                                                       st
               Meal Program Application must be completed returned and processed (one for each family). This is not available until the 1
               day the child attends school with the exception of Pre-K

               If you are not the birth parent(s), you must provide documents showing you have custody

               $10 NON-REFUNDABLE Activity Fee




                                     INFORMATION FOR PARENTS
                                                                                 st
               Student’s School Supplies (must bring the 1 day attending)

                                                                    st
               Uniforms MUST be worn from the 1 day attending school

               All Pre-K-12 students are required to comply to State attendance laws

               Pre-K students must qualify for state & Fed funded programs (income, language, other) ASK FOR FORM

               All children must be completely toilet trained!

               Pre-K must have turned age 4 by September 1 of school year

               Kindergarten must have turned age 5 by September 1 of school year


 Disclosure Statements:
 It is the policy of Faith Family Academy Charter School to comply with non-discrimination provisions of all federal and state laws. FFA admits students without regard to race, religion, color,
 gender, age, national origin, ethnicity, disability, academic, artistic, athletic ability, marital status, political belief, limited English proficiency or the district the child would otherwise attend.
 FFA will deny admission to students with documented histories of a criminal offense, juvenile court adjudication, or discipline problems under TEC Chapter 37, Subchapter A. If anyone
 believes that they have been discriminated against, they should write to the Secretary of Education, Washington D.C. 20250.
 Child Find - a free appropriate public education (FAPE) is provided to all individuals with disabilities, ages 4-21, who qualify for special education services. With the assistance of the Texas
 Education Agency, ESCs, and the Early Childhood Intervention (ECI) program, LEAs must ensure that early intervention services are made available for those children, ages 0-3, with an
 identified need.

                                                                                                                                                                                                            2
          Educational Goals for School Year 2012-2013
       We, at Faith Family Academy, are asking for your input regarding
       goals for your child as we create a more comprehensive
       educational plan for your child. Please complete this form and
       return it with your child’s registration papers. If you have any
       questions, please contact the Counselors’ Office.

Student Name:                                                    Grade:

Check all that apply and circle one response as appropriate:

      My child will meet the annual credit requirements necessary per FFA Handbook in
       order to be promoted to the next grade level.

      My child will pass the State of Texas Assessments of Academic Readiness (STAAR)
       Test/ End of Course (EOC) exam.

      My child will make passing grades in all subject areas. This means that he/she will utilize
       tutoring at the school or we will hire a private tutor.

      My child will graduate from high school on the following graduation plan:            (Circle one)
             Minimum (with approval)              Recommended

      My child will graduate from high school (9th grade through graduation):          (Circle one)
             within 4 years           within 3 years     within 3 ½ years


      My child will take correspondence courses to earn additional credits.

      My child will be involved in the following extracurricular activities: (Circle more than one)

              Athletics                          Choir/Theater
              UIL Academic Teams                 Volunteer Work
              Part-time employment               Clubs
              Other:

      Other goals are listed on the back of this sheet.

Following graduation, I will encourage my child to: (Circle one)
      enter the workforce                         enlist in the military
      attend a technical training school          attend a 2 year community college
      attend a 4 year college or university



   Signature of Parent/Guardian:


                                                                                                           3
                                        2012-2013 Schedule Request Form

           Name : ___________________________________________                     Grade: _____________



The required classes are:
      9th           Algebra 1              English 1           World Geography                   Biology
        th
     10             Geometry               English 2            World History                   Chemistry
        th
     11           Math                     English 3             US History                      Physics
                 Models
     12th           Algebra 2              English 4           Government/Econ             Science 4
    Elec.         Pre-Calculus            PE /Health          Prof comm. (speech)     Anatomy & Physiology
                   Tech class         French/Spanish 1        French/Spanish 2/3            Physics

The classes I want are:    (PLEASE NUMBER 1-5, 1 BEING THE MOST IMPORTANT)

       Yearbook              Digital Imaging (DIM)            French/Spanish            Intro to Languages
      Animation 1                Dollars & Sense              Money Matters                      Choir
        Theatre                   One Act Play              Electronic Media 1          Electronic Media 2
  Into Health Science        Medical Microbiology         Business Tech (BIMM)       Computer Programming
     Earth Science          Principals of Human Service   Athletics – which sport?    Art (1, 2, 3 – Circle One)

  Please note: If you sign up for athletics, you are required to get a physical. If you do not return your
 physical by August 3, 2012, you may either be dropped from the class or you might remain in athletics
                         but will be unable to participate as a part of the team.

                     The classes I need to retake are:     (PLEASE FILL IN THE BLANK)




                           The pathway I want to follow is: (PLEASE CIRCLE)
     Art &            Finance         Health               IT        Business                       Human
Communication                        Science                                                        Services


                          EOC/STAAR/TAKS Scores:           (the previous 2 years if possible)
  SUBJECT                  8th         9th                      10th              11th                12th
     ELA
    MATH
  SCIENCE
  SOCIAL S.

                                                                                                                   4
                                                                    Faith Family Kids, Inc.
                                                                            dba
                                                          FAITH FAMILY ACADEMIES
                                300 West Kiest Blvd., Dallas, Texas 75224 – ph. 214-375-7682 – fax 214-375-7681
                               701 Ovilla Road, Waxahachie, Texas 75167 – ph. 972-937-3704 – fax 972-937-5806



                                        ENROLLMENT STUDENT PERSONAL INFORMATION
                                                                School year: ____________Date:___________
Last Name (As on Birth Certificate.)                                                          Social Sec. No.

First Name (As on Birth Certificate)                                                          Gender(male-female)

Middle Name (As on Birth Certificate)                                                         Home Language

Preferred Name                                                                                Grade (2012-2013)

Generation (Jr,I,II)                                                                          Foster Child?
                                                                                                                     YES                  NO
Birth date                                        Birth place                                 Home Phone #


Ethnicity (circle one):             Black              Hispanic                 Anglo              Asian              Native American

Student lives with (Name):                                                                                Relationship:


Street Address:

City                                                            State              Zip

Mailing Address (if differs)

City                                                            State              Zip


Name of Local Public School Campus/District this student would attend if not attending any Charter School or private school:


List last 3 schools attended (at least list the last 3 years) and dates/grades while attending the school. (If more than 3 please use back of sheet).
  School Name                                 School District           City                               Grades/Dates of Attendance




Please list all siblings that are/will be attending Faith Family Academy:

_____________________________________________________                              _______________________________________________________

_____________________________________________________                              _______________________________________________________

_____________________________________________________                              _______________________________________________________

How did you hear about Faith Family Academy Charters? Please give name, where appropriate.
__________________________ Friend                 ____________________Internet             _________________PTSO

__________________________ Teacher                         ____________________Relative                  ________________Driving By

__________________________ FFA Employee                    ____________________ Marquee                  ________________ Other




                                                                                                                                                        5
                        ENROLLMENT STUDENT PERSONAL INFORMATION cont.

Student’s Name ____________________________________________ Grade 2012-2013 _______________

                                  1st CONTACT (Parent, Guardian, Other)
Last Name                                                E-mail address

First Name                                               Parent ID/Drivers License #

Relationship                                             Employer Name and Address

Custody (circle one)        yes          no

Street Address

City/State/Zip                                           Work E-mail

Mailing Address                                          Home Phone

City/State/Zip                                           Mobile Phone



                                  2ND CONTACT (Parent, Guardian, Other)
Last Name                                                E-mail address

First Name                                               Parent ID/Drivers License #

Relationship                                             Employer Name and Address

Custody (circle one)        yes          no

Street Address

City/State/Zip                                           Work E-mail

Mailing Address                                          Home Phone

City/State/Zip                                           Mobile Phone



Please indicate academic level of child’s previous work: 90-100_______ 80-90_______ 70-80_______ below 70_______

Has child ever failed in school? Yes______ No______ When? ________________ Where? ______________
Explain: _________________________________________________________________________________

Has your child attended Summer School? Yes______ No______ When? ___________ Where? ___________
Explain: _________________________________________________________________________________

Has your child ever been in Special Education or Section 504? Yes_____ No_____ When? ______________
Explain:_________________________________________________________________________________

What was the last school your child was in a Special Education Program? ____________________________

Has your child ever been in a Gifted and Talented Program? Yes_____ No_______ When?_______________

Has child ever been eligible for a public education grant (PEGS)? Yes_______ No_______ When? ________
Explain: _________________________________________________________________________________

                                                                                                                   6
                                                                 Parent, Parents, Guardian Agreement
Student’s Name ______________________________________Grade 2012-2013 ______________ Initial                                                                                                                ↓
Initial each paragraph confirming agreement and support with Vision and Goals of FFA

  *1. “I/We give permission for my/our child to take part in all school activities, including sports and school-
sponsored trips away from the school premises, and absolve the school from liability to me/us or my/our child
because of any injury to my/our child at school or during any school activity.”

  *2. “I/We agree to uphold and support the high academic standard of the school by providing a place at home
for my/our child to study and giving my/our child encouragement in the completion of any homework or
assignments.”

  *3. “I/We appreciate the standards of the school and will not tolerate profanity, obscenity in word or action,
dishonor or disrespect to their peers and school personnel.”

  *4. “I/We hereby agree to support all regulations of the school in the applicant’s behalf and authorize this
school to employ discipline as it deems wise and expedient for the training of my/our child.”

  *5. “I/We understand that parental participation is highly encouraged. Volunteer help at the Academy is greatly
appreciated.”

  *6. “I/We will have our child at the school every day on time. In the event of repeated lateness or absences,
without a doctor’s permit, I understand that my child will be asked to return to his/her previous school.”

   *7. “I/We will make sure that my student is in standard uniform every day as set forth in the student handbook.”

  *8. “I/We as parents understand that if any drugs or drug paraphernalia is found in my child’s possession,
he/she could have his/her enrollment revoked (TEC 37.006). I/We further understand that if my student is
conversing with others about drugs, except in a teaching setting, he/she may have their enrollment revoked.”

   *9. “I/We understand that the school reserves the right to revoke enrollment of any child who fails to comply
with the established regulations and discipline. I/We also understand that I/we will be financially responsible for
all damage to the school property including lost or damaged textbooks, caused by my/our child.”

  *10. “I/We understand that my child’s enrollment is contingent upon satisfactory discipline records from his/her
previous school. I/We understand that enrollment will be revoked upon unsatisfactory discipline records”.

  *11. “I/We will conform to the Internet & Computer Use policy. I/We understand the consequences of violating
this policy may cause revocation of enrollment.”

  *12. “Faith Family Academy has four and/or six report cards. I/We understand that it is my responsibility to sign
these report card(s), and to inquire for a copy if not received at end of that marking/grading period.”

  *13. “I/We as parents understand that I/we are obligated to keep the school informed concerning current phone
numbers (work & home) and addresses as or before they change.”

  *14. “I/We will read the Student Handbook, agree to complete parent orientation, and I/we understand the terms
stated on this application and agree thereto.”

 *15. “I/We give permission for the school to take photographs and/or videos of my child as part of the
educational process (including campus website and yearbook)”.

 *16. It is MANDATORY that pupils who exhibit symptoms of communicable diseases be excluded from classes
until re-admission is acceptable to the Academy’s Health Professionals or with a Doctor’s Note.

*17. “I/We understand that the $10 Activity Fee is NON-REFUNDABLE and will not be reimbursed.”
I have completed the required information and obtained the required documents. My child will comply with the uniform standard and bring school supplies beginning with the first day. I confirm that all
information in this document is true and complete. I understand that giving false information or withholding information will mean that my child’s enrollment at FFA can be revoked.

__________________________________________________                                                          __________________________________________________
Signature of Parent or Guardian            Date                                                             Signature of Parent/Guardian               Date
                                                                                                                                                                                  SST-130 2/13/2006
                                                                                                                                                                                                  7
                                                       Faith Family Academies
                                                       Home Language Survey




Student’s Name_____________________________________________________________________________________
Nombre del estudiante Last/Apellido       First/Nombre                       Middle/Segundo Nombre

Date of Birth_____________________________________________________ ID#______________________________
Fecha de nacimiento: Month/Mes        Day/Dia       Yeat/Aho

School______________________________________ Grade_______________ Date Enrolled_____________________
Escuela                                             Grado                        Fecha de entrada


Home Language Survey (informacion sobre el idioma quo se habla en casa)

1.   What language is spoken in your home most of the time? _________________________________________________
     Cual es el idioma que mas se habla en su hogar?

2.   What language does your child (do you) speak most of the time? __________________________________________
     Cual es el idioma que su Nino(a) habla mas?

3.   What language did your child learn to speak first? _____________________________________________________
     Cual es el idioma que hijo(a) aprendio primero?

4.   Where is your child’s place of Birth? (Country) _______________________________________________________
     Pals natal de nacimento?

5.   Has your child lived outside the U.S. for two (2) or more consecutive years? Yes/Si ___________ No___________
     Ha residido su hijo(a) fuera de los Estados Unidos por mas de dos (2) anos consecutivos?

6. Did your child attend school when residing outside the U.S.?                       Yes/Si ___________ No ___________
   Asistio su hijo(a) a la escuela mientras estuvo fuera de Los Estados Unidos?

7. Has your family moved during the last three years from one school district to another in the state of Texas
   or across states?                                                              Yes/Si ___________ No ____________
   Se ha movido su familia durante los ultimos tres anos de un distrito escolar para otro en el estado de Tejas
   6 a traves de todos los Estados Unidos?

8. Was this move due to the need to find temporary or seasonal work in agriculture or related areas such as
   packing, processing, harvesting, crop, dairy produce, fishing, forest work, etc.? Yes/Si ____________ No __________
   fue la razon de su movimiento para buscar trabajo temporal de estacion en agricultura, o en areas
   relacionadas para empacar, procesar, recoger producto de cosecha, productos lacteos, de pescaderia,
   O de trabajos forestales?


Date of FIRST entry into ANY school in the U.S.A. _______________________________________________________
Fecha de PRIMER ingreso en CUALQUIER escuela en los Estados Unidos.

Grade/Grado ______________ Month/Mes ___________________________________Year/Aho__________________


Signature of Parent __________________________________________________________ Date ________________
Firma del Padre/Guardian                                                                  Fecha


                                       White-Cumulative Folder   ALL Yellow-ESL/Bilingual Department
                                                                                                                    SST-130 2/13/2006




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