SATSUMA CHRISTIAN SCHOOL

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					                          SATSUMA CHRISTIAN SCHOOL
                                  P.O. BOX 610
                               SATSUMA, AL 36572
                                  (251) 675-1295

                                Registration for 2012-2013

Application Date: __________________                         Entering Grade: ____________

Name _________________________________________________________________________
             Last         Middle       First               (Name to be called)

Birthdate: __________ Age____Gender_____ Race_____ Social Security #_________________

FAMILY INFORMATION:
Home Address:__________________________________________________________________
                          Street                City            State          Zip
Father’s Name:___________________________Email:_________________________________
Employer:______________________________________ Occupation:_____________________
Home Phone:__________________ Cell:_____________________ Work:__________________
Mother’s Name:___________________________Email:_________________________________
Employer:______________________________________ Occupation:_____________________
Home Phone:__________________ Cell:_____________________ Work:__________________
Parents are: Married_______Divorced_______Separated_______Single_______Widow_______
Name/relationship of person who has custody of the child?_______________________________
(Legal documentation of custody and visitation rights must be submitted with registration.)
Person responsible for student’s account?_____________________________________________
Billing address (if different from above)______________________________________________
SIBLING INFORMATION:
NAME                              AGE                           SCHOOL ATTENDING
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Last school student attended______________________________________________________
Has student ever repeated a grade?_______ If yes, which grade?__________
High school students only: Has your child taken any part of the Alabama High School
Graduation Exam?_______ If yes, which portion(s)?___________________________________
Church Affiliation:______________________________Regular Attendance?________________
Reason for choosing Satsuma Christian School?________________________________________
______________________________________________________________________________

LIST NAMES OF PEOPLE ALLOWED TO PICK-UP STUDENT (Include Parents):
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

LIST NAME(S) OF ANYONE NOT ALLOWED TO PICK UP STUDENT OR ANYONE WHO
HAS ON-CAMPUS VISITATION RESTRICTIONS:___________________________________
______________________________________________________________________________
                         EMERGENCY/MEDICAL INFORMATION

LIST NAMES AND PHONE NUMBERS OF PEOPLE TO BE CONTACTED IN THE EVENT
OF SICKNESS OR EMERGENCY (Please list in the order you wish to be contacted, including
parents):
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Name/phone number of child’s physician:____________________________________________
Name/policy number of child’s insurance:____________________________________________
Does student have vision or hearing problems?_____ If yes, describe_______________________
______________________________________________________________________________
Has student been tested for learning or speech difficulties, received special help for reading, or
had psychological testing?___________ If yes, please explain and give dates:________________
______________________________________________________________________________
If your child has had psychological testing, does he/she have an IEP?_______________________
(Satsuma Christian School reserves the right to verify test results.)
Please list any allergies your child has:_______________________________________________
Please list any health conditions/disabilities your child has and any special instructions regarding
the condition: Diabetes_____ Heart Condtion____ Seizures____Asthma____
______________________________________________________________________________
______________________________________________________________________________

Please list any medications your child takes regularly:___________________________________
If your child needs to take medication during school hours, it will has to be kept in the school
office in the original labeled container and a medication authorization form will need to be filled
out by the parent. Medication may not be kept in the student’s book bag/purse.

                            Permission to Obtain Medical Treatment
If your child should become ill or suffer an accident while at school, you will be contacted
immediately. In the event that we are unable to contact you immediately, the school and/or its
designated staff is authorized to seek and obtain such attention, treatment, and services for your
child as may be deemed necessary.
“I, the parent/guardian of ____________________________, agree to assume responsibility for
payment of all medical costs incurred.”
If emergency treatment is required and parents cannot be reached, authorization is hereby granted
to: 1. Call for an ambulance for transportation to hospital: Yes____ No____
       Which hospital is preferred?__________________________________________________
    2. Administer any treatment deemed necessary by the physician: Yes____ No____

Signature of parent/guardian_____________________________________ Date______________


*Satsuma Christian School has my permission to administer first aid for cuts, scrapes/scratches,
etc.
______________________________________________________________________________
               Parent Signature                                 Date
                   CHURCH SCHOOL ENROLLMENT FORM

       School Year 2012/2013             Public School District Mobile County

              I. TO BE COMPLETED BY PARENT OR GUARDIAN

Student’s Name __________________________________Home Phone _____________

Home Address___________________________________________________________

Date of Birth ____________________________________________Grade ___________

Parent/Guardian’s Name ___________________________Home Phone______________

Home Address ___________________________________________________________

Church School of Enrollment Satsuma Christian School School Phone 251-675-1295

Address P.O. Box 610 (5600 Old Hwy 43) Satsuma, AL 36572

SIGN HERE____________________________________________________________
                Signature of Parent or Guardian     Date

          II. TO BE COMPLETED BY CHURCH SCHOOL ADMINISTRATOR

Church School Name Satsuma Christian School School Phone 251-675-1295

Address P.O. Box 610 Satsuma, AL 36572

________________________________________________________________________
Date of student enrollment    Signature of Church School Administrator


      III. CONSENT FOR NOTIFICATION OF STUDENTWITHDRAWAL

        I hereby give consent to the administrator of Satsuma Christian School to notify
the public school superintendent should the above named student cease attendance at said
school.

SIGN HERE ___________________________________________________________
                Signature of Parent or Guardian           Date
                                     FORM OF AFFIDAVIT
                                      (K3, K4, and K5 only)
                                     (For Parent/Guardian)

                                       STATE OF ALABAMA
COUNTY OF MOBILE

Before me, a Notary Public in and for said State and County, appeared
______________________
                                                                           (Print name of parent/legal guardian)
and is known to me, after being duly sworn or affirmed, says as follows: That affiant, is the
parent or legal guardian of the minor child _____________________________; that affiant has
                                               (Child’s Name)
been notified by Charnel Et-Tawil, Satsuma Christian School Principal, a representative of First
Baptist Church of Satsuma School and Day Care Church / School, that said church or school has
filed notice and is exempt under law from regulation by the Department of Human Resources.

____________________________________PARENT/LEGAL GUARDIAN
       (Parent/Legal Guardian’s Signature)


Sworn, or affirmed to and subscribed before me this
_______________day of________________, 20_____.


__________________________SEAL:
 (NOTARY PUBLIC)


My Commission Date Expires:________________
             SATSUMA CHRISTIAN SCHOOL MISSION STATEMENT

The mission of Satsuma Christian School is to include giving each student an opportunity to
come to know God through Jesus Christ, giving each student guidance into a positive Christian
philosophy of life, and giving each student full opportunity and the necessary resources to
develop to his or her full potential, spiritually, academically, socially and physically. By doing
so, Satsuma Christian School will strive to help ensure that students attain high academic
excellence in preparation for advanced curriculum studies on the secondary level while
emphasizing the Bible, the Word of God, in school life and daily studies so that students and
faculty reflect Christian morals and ethics in their daily lives.



                                   COMMITMENT FORM

    As parents/guardians of the children listed, we commit ourselves to:

           Uphold and support the mission and ministry of Satsuma Christian School (without
            reservation) through participation and prayer.

           Work closely with teachers in carrying out all aspects of each child’s education.

           Support the total school curriculum and program of instruction as specified by the
            School Ministry Team and Administration.

           Partner with Teachers and Administration in the spiritual nurturing of each child.

 We agree to:
 1. Read and follow all items contained in the Parent/Student Handbook.
 2. Read the Fee Policy and pay all required fees by specified due dates.

 We, the parents/guardians of ___________________________________________, have read
 and understand the mission statement and commitment form.

  Parent/Guardian Signature(s):
  __________________________________________________ Date: __________________
  __________________________________________________ Date: __________________
  Person responsible for paying the bill:___________________________________________
  Address: __________________________________________________________________
  Telephone numbers: _________________________________________________________


NOTICE OF NONDISCRIMINATORY POLICY AS TO STUDENTS: SATSUMA
CHRISTIAN SCHOOL ADMITS STUDENTS OF ANY RACE, COLOR, NATIONAL AND
ETHNIC ORIGIN TO ALL THE RIGHTS, PRIVILEGES, PROGRAMS, AND ACTIVITIES
GERNERALLY ACCORDED OR MADE AVAILABLE TO STUDENTS AT THE SCHOOL.
IT DOES NOT DISCRIMINATE ON THE BASIS OF RACE, COLOR, NATIONAL, OR
ETHNIC ORIGIN IN THE ADMINISTRATION OF ITS EDUCATIONAL POLICIES,
ADMISSION POLICIES, OR OTHER SCHOOL ADMINISTRATIVE PROGRAMS.
                  Satsuma Christian School Admission Policy
                           (Returning and Initial Admission)

          Students must meet appropriate age requirements by October 1st. Entrance
examinations will be administered to students entering 1st - 11th grades; K5 students will
be subject to an academic screening. Students whose examination results indicate that
they are on the proper grade level may be admitted to that grade. If, however, it appears
that a student would have difficulty at the grade level for which has been applied for,
he/she may be admitted at a lower grade level.

       Many factors will be considered in approving applications for admissions and re-
enrollment. Some of the more important ones are as follows:

       1. Conduct, attitude and grades of the student in previous years.
       2. Achievement level as indicated by school grades, achievement tests, and/or
          entrance exams.
       3. A previous history of use of alcohol, tobacco, or other drugs, or a record of
          truancy.
       4. Consideration of past tuition payment and account status.
       5. Whether or not the student and family will make an unreserved commitment
          to the standards and policies of Satsuma Christian School.
       6. K3 and K4 students must be fully potty-trained before the school term begins
          and will not be allowed to wear pull-ups.
       7. For the welfare of your child, it is imperative that office personnel be
          informed of any existing medical condition or limitation upon registration.


PLEASE NOTE:
Students who have been suspended ( in-school or out-of-school) or expelled from a
previous learning institution will not be considered for enrollment.




*I have read and agree to the above stated policy.

Parent Signature_______________________________________Date_____________
                                      Satsuma Christian School
                                        EXTENDED CARE
                                       Registration 2012-2013
PLEASE PRINT CLEARLY

CHILD’S NAME___________________________________GRADE________________

       BEFORE SCHOOL CARE                           AFTER SCHOOL CARE
       Full time_____Drop-in_____                   Full time_____Drop-in_____
       ($25.00 monthly) ($6.00 paid daily)         ($75.00 monthly ($6.00 paid daily)
                                                   *K3-K5 p/u by 3:00 for no daily fee
                                                   *1st-5th p/u by 3:15 for no daily fee
                                                   *6th-8th p/u by 3:30 for no daily fee

Extended care is available for all SCS students. Before school care is available from 6:30 to 7:30
a.m. After school care is provided until 6:00 p.m.

*If your child is registered as full time, you will be billed at a full time rate unless you call and
make other arrangements.

Home address____________________________________________________________
Home phone___________________SS#_______________________Age_____Sex_____
Father’s name__________________________Wk#_________________Hm#_________
                                                  Cell #____________________________
Mother’s name_________________________Wk#_________________Hm#_________
                                                  Cell #____________________________
Name and phone numbers of persons allowed to pick up your child or assume responsibility for
your child in case of emergency when parents cannot be contacted:
Name________________________________________Phone #’s___________________
Name________________________________________Phone #’s___________________

*Any health information we need to be aware of:________________________________

Permission is granted to meet the needs of my child in the case of emergency:
Parent Signature__________________________________________________
Hospital Preferred_______________________Doctor__________Phone_____________
If your doctor is unavailable, permission is granted to engage doctor on call: (circle one) Yes No

*Please list any family member that is NOT ALLOWED, under any circumstances, to pick up
your child (i.e. estranged parent). Please give the school the appropriate legal documentation.
Name_________________________________________Relationship______________________
Name_________________________________________Relationship______________________
……………………………………………………………………………………………………….
                                    PARENTAL AGREEMENT

1. I will pay required fee for each month or day, depending on which program I have chosen.
2. I will not hold the school/daycare caregivers liable for any accidents or injuries during related
   activities.
3. I give permission for my child to be treated by a doctor in case of injury in the event that I am
   unable to be reached.
4. I agree to discipline, as outlined in the Satsuma Christian School Conduct/Discipline Policy.

    _________________________________________________ _______________________
                     Parent Signature                           Date
                                    SATSUMA CHRISTIAN SCHOOL
                                    K3-3rd GRADE UNIFORM POLICY
                                              2012-2013
         Everyday Wear - Girls
         **All girls’ jumpers, skirts/skorts or shorts must be to the knee.**
         Khaki Shorts or Khaki Pants- All shorts and pants must be uniform, pleated or flat front.
         No Lowrise, Bell-bottoms, Corduroy, Cargo, Carpenter (Utility), or jeans. Uniform attire may be
         purchased from any store as long as it is labeled UNIFORM, with the exception of chapel plaid
         which must be purchased from Zoghby’s uniforms.

         Khaki Skirt/Skort
         Plaid Jumper/Skort (Purchased from Zoghby’s Uniforms)
         Light Blue or Navy Polo Shirts or Peter Pan Shirts
         Black or Brown Belt (K3 & K4 optional)
         Black, Navy or White Socks (solid) Low cut socks are fine.
         White, Black, Navy, Red, or Gray Tennis Shoes, multicolor allowed.
         (No shoes with lights, high tops, or skates)

         Everyday Wear – Boys
         Khaki Shorts or Khaki Pants- All shorts and pants must be uniform, pleated or flat front.
         No Corduroy, Cargo, Carpenter (Utility), or jeans.
         Light Blue or Navy Polo Shirts
         Light Blue Oxford Shirts
         Black or Brown Belt (K3 &K4 optional)
         Black, Navy or White Socks (solid) Low cut socks are fine.
         White, Black, Navy, Red, or Gray Tennis Shoes, multicolor allowed.
         (No shoes with lights, high tops, or skates)

         Chapel Wear K-3 through 3rd Grade
         Boys
         Khaki Pants
         Light Blue Oxford Shirts
         Bowties (Solid Navy K-3, K-4 & K-5)
         Neckties (Solid Navy 1st through 3rd Grade)
         Navy, Brown, or Black Casual/ Dress Shoes (solid)
         Black or Navy Socks (solid)

         Girls
         Plaid Jumper/ Skort (Purchased from Zoghby’s Uniforms)
         Light Blue Peter Pan Shirts with plaid Jumper/Skort
         Black or Navy Socks, Tights, Leggings
         Navy, Brown, or Black Casual/Dress Shoes (solid)

         Winter Wear
         Light Blue or Navy Long-Sleeved Polo
         White or Navy Turtleneck under uniform shirt
         Solid Color Navy, Red, Gray or White Pullover or Cardigan Sweater, Sweatshirt, or Windbreaker
         (School jackets may be purchased from Zoghby’s.)
         Over-coat may be worn but not in the classroom unless they are the above mentioned colors.

If you have difficulty finding items, please check with Zoghby’s Uniforms. If they do not have the item in
stock, they will order it for you. Orders need to be placed early to insure arrival for the beginning of
school. (If your child’s chapel skirt is not in by the time school starts, she may wear a khaki skirt until your
order arrives.) Zoghby’s phone # is 342-0039.
Uniform policy is subject to change as deemed necessary by administration.

                        *4th-8th Grade Uniform Policy on Reverse Side*
                                    SATSUMA CHRISTIAN SCHOOL
                                  4TH – 8TH GRADE UNIFORM POLICY
                                               2012-2013

        Everyday Wear- Girls ** All girls’ skirts/skorts and shorts must be to the knee.**
        Khaki Shorts or Khaki Pants- All shorts and pants must be uniform, pleated or flat front.
        No Lowrise, Bell-bottoms, Corduroy, Cargo, Carpenter (Utility), or jeans. Uniform attire may be
        purchased from any store as long as it is labeled UNIFORM, with the exception of chapel plaid
        which must be purchased from Zoghby’s uniforms.
        Khaki Skirt/Skort
        Plaid Skirt/Skort (Purchased from Zoghby’s)
        Light Blue, Navy or White Polo Shirts
        Black or Brown Belt
        Black, Navy or White Socks (solid) Low cut socks are fine.
       White, Black, Navy, Red, or Gray Tennis Shoes, multicolor allowed.
        (No shoes with lights, high tops, or wheels)

         Everyday Wear- Boys
         Khaki Shorts or Khaki Pants- All shorts and pants must be uniform, pleated or flat front.
         (No Corduroy, Cargo, Carpenter (Utility), or jeans.
         Light Blue, Navy, or White Polo Shirts
         Black or Brown Belt
         Black, Navy, or White Socks (solid) Low cut socks are fine.
         Navy, Brown, or Black Shoes (solid)
         White, Black, Navy, Red, or Gray Tennis Shoes, multicolor allowed.
         (No shoes with lights, high tops, or wheels)

         Chapel Wear- Girls
         Plaid Skirt/Skort (Purchased from Zoghby’s)
         Light Blue or White Oxford or Peter Pan Shirts
         Black or Navy Socks, Tights, or Leggings
         Navy, Brown, or Black Casual/Dress Shoes (solid)

         Chapel Wear- Boys
         Khaki Pants
         Light Blue or White Oxford Shirts
         Solid Navy Neckties
         Navy, Brown, or Black Casual/ Dress shoes (solid)
         Black or Navy Socks (solid)

         Winter Wear
         Light Blue, Navy Blue or White long-sleeved polo
         Solid white or navy long-sleeved shirt under uniform shirt
         Solid Color Navy, Red, White, Gray, or Black Pullover or Cardigan Sweater, Sweatshirt, or
         Windbreaker- (School jackets may be purchased from Zoghby’s.)
         School Sports Activity Jacket
         Over-coat may be worn but not in the classroom unless they are the above mentioned colors.

If you have difficulty finding items, please check with Zoghby’s Uniforms. If they do not have the item in
stock, they will order it for you. Orders need to be placed early to insure arrival for the beginning of
school. (If your child’s chapel skirt is not in by the time school starts, she may wear a khaki skirt until your
order arrives.) Zoghby’s phone # is 342-0039.
Uniform policy is subject to change as deemed necessary by administration.

                                    *K3-3rd Grades on reverse side*
                                    SATSUMA CHRISTIAN SCHOOL
                                    9th-11th GRADE UNIFORM POLICY

                                                  2012-2013

         Everyday Wear- Girls ** All girls’ skirts/skorts and shorts must be to the knee.**
         Khaki Shorts or Khaki Pants- All shorts and pants must be uniform, pleated or flat front.
         No Lowrise, Bell-bottoms, Corduroy, Cargo, Carpenter (Utility), or jeans. Uniform attire may be
         purchased from any store as long as it is labeled UNIFORM, with the exception of chapel plaid
         which must be purchased from Zoghby’s uniforms.
         Khaki Skirt/Skort
         Plaid Skirt/Skort (Purchased from Zoghby’s)
         Red or Gray Polo Shirts
         Black or Brown Belt
         Black, Navy or White Socks (solid) Low cut socks are fine.
         White, Black, Navy, Red, or Gray Tennis Shoes, multicolor allowed.
         (No shoes with lights, high tops, or wheels)

         Everyday Wear- Boys
         Khaki Shorts or Khaki Pants- All shorts and pants must be uniform, pleated or flat front.
         (No Corduroy, Cargo, Carpenter (Utility), or jeans.
         Red or Gray Polo Shirts
         Black or Brown Belt
         Black, Navy, or White Socks (solid) Low cut socks are fine.
         Navy, Brown, or Black Shoes (solid)
         White, Black, Navy, Red, or Gray Tennis Shoes, multicolor allowed.
         (No shoes with lights, high tops, or wheels)

         Chapel Wear- Girls
         Plaid Skirt/Skort (Purchased from Zoghby’s)
         Light Blue or White Oxford Shirts
         Black or Navy Socks, Tights, or Leggings
         Navy, Brown, or Black Casual/Dress Shoes (solid)

         Chapel Wear- Boys
         Khaki Pants
         Light Blue or White Oxford Shirts
         Solid Navy Neckties
         Navy, Brown, or Black Casual/ Dress shoes (solid)
         Black or Navy Socks (solid)

         Winter Wear
         Red or Gray long-sleeved polo
         Solid white long-sleeved shirt under uniform shirt
         Solid Color Navy, Red, White, Gray, or Black Pullover or Cardigan Sweater, Sweatshirt, or
         Windbreaker-(School jackets may be purchased from Zoghby’s.)
         School Sports Activity Jacket
         Over-coat may be worn but not in the classroom unless they are the above mentioned colors.

If you have difficulty finding items, please check with Zoghby’s Uniforms. If they do not have the item in
stock, they will order it for you. Orders need to be placed early to insure arrival for the beginning of
school. (If your child’s chapel skirt is not in by the time school starts, she may wear a khaki skirt until your
order arrives.) Zoghby’s phone # is 342-0039.

               *Uniform policy is subject to change as deemed necessary by administration.
                                   Satsuma Christian School
                                          Fee Policy
                                    2012-2013 School Year
                    **All Fees are Non-refundable and Subject to Change**
                                         Registration

Returning SCS students                January 24 – January 31            $100.00*
*In-house registration price increases to $125.00 after February 1

Public registration opens                 February 1 – March 7            $125.00*
                            *All registration after March 7 will be $150.00
                                 Registration closes on May 25, 2012.


                                              Tuition
K3-K4                              $210.00 month                  $2100.00 total
K5                                 $220.00 month                         $2200.00 total
1st- 5th                           $230.00 month                         $2300.00 total
6th-8th                             $245.00 month                        $2450.00 total
9th-11th                            $255.00 month                        $2550.00 total

  Tuition is based on a ten-month payment schedule and is due on the 1st of each month. A
  $30.00 late fee per child is assessed on the 6th of the month for any past due balances. The
  student is automatically withdrawn on the 11th of the month unless account is paid in full; this
  includes all extracurricular fees (sports, cheerleading, etc.).

 A 10% discount will be given for additional children living in the same household, having the
same parent or legal guardian. This discount will apply to the lowest tuition amount(s). A $50.00
discount will be given for paying a student’s total tuition and all fees in full by August 1st,
2012. There will be a $30.00 service charge on returned checks. If not paid in full within 10 days,
the student will be withdrawn on the 11th day of the month and no more checks will be accepted.
                                                Fees
Maintenance                        Book Rental                             Activity/Technology
$100.00 (per family)               K3-K4 $130                              K3       $125
                                   K5-3rd $170                             K4       $175
                                   4th-8th $210                            K5       $195
                                   9th-11th (High school books             1st-3rd  $245
                                             purchased by                  4th-8th  $250
                                              parent/guardian)             9th-11th $250

ATHLETIC FEE                        CHEERLEADING                     BAND             K5/8th
Graduation Fee
$100                                   $25                              $60             $60

               *Please note: Book fees and due dates on other fees have changed.

           NEW SCS STUDENTS                               RETURNING SCS STUDENTS

Reg./Book Fee          Due at Registration         Reg. Fee              Due at Registration
Maint. Fee             Due June 1st                Book/Maint.           Due June 1st
Act/ Tech              Due July 1st                Act/Tech              Due July 1st
Tuition                Due Aug 1st                 Tuition               Due Aug 1st

				
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