Re-Enrollment Form

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					                                         APPLICATION FOR RE-ENROLLMENT

This application is for students presently enrolled who desire to return for the 2010 – 2011 academic year. Please
return this re-enrollment form as soon as possible. The $165.00 registration fee must be paid by July 1st unless
other arrangements are made with the office.

McKay Scholarship students are not required to pay this fee.


1.   Prior year’s school balance must be paid in full.
2.   Re-enrollment fees paid prior to start of new school year.
3.   Re-enrollment application completed and turned into school office.
4.   A letter from the family’s pastor affirming that the applicant and at least one parent are active members,
     regularly attending and supporting their church.


Student’s Name                                                          Sex                        Age

Home Address                                                   City                                Zip Code

Phone                                                          Emergency Phone

Church                                                                                             Attend regularly: YES / NO

Pastor                                                                  Phone

Name of other children in family:

Name                                         Age                        Name                                         Age


“I understand that the educational program is an integral part of the church ministry which I am expected to

“I hereby commit to assume my Scriptural responsibility to financially support the church’s educational ministry.”

“I understand that my child is expected to take part in church educational activities, including sports and sponsored
trips away from the educational facility, and I absolve the church from liability to me or my child because of any
injury to my child at supervised church activities.”

“I agree to uphold and support the high academic standard of the educational ministry by providing a place at
home for my child to study and by encouraging my child in the completion of homework or assignments.”
“I appreciate the standards of the educational ministry and do not tolerate profanity, obscenity in word or action,
dishonor to the Godhead or the Word of God, or disrespect to the staff of the church. I hereby agree to support
regulations published in the church educational handbook on the applicant’s behalf and authorize the church to
employ discipline as it deems wise and expedient for the training of my child.”

“I understand that the church reserves the right, after parental conference, to dismiss any child who fails to comply
with the established regulations and discipline or whose parents do not assume their responsibility to the
educational ministry.”

Signature of Father                                                       Signature of Mother

Date                                                                      Date
C:\PCCS Documents\School Office Forms\Re-Enrollment Form.doc (04-07-03)