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APPLICATION FOR ADMISSION TO
SEVENTH-DAY ADVENTIST CHURCH SCHOOLS
NOTE: Please fill out a separate application for each child applying for admission. 1. ________________________
2. _________________________________________________________ 3. ____ 4. ____ 5. ____________ 5a. ____________ 6. _____________
Last First Middle Grade Sex Mo./Day/Yr. Years/Mos. Date Baptized in
Child’s Full Legal Name Entering Birthdate Age SDA Church
7. Place of Birth_________________________ (Country) 8. Ethnic Origin (check one) Caucasian ___ Black ___ Hispanic ___ Oriental ___ Am. Indian ___ Other _______________________ (Specify)
(For Federal Government and General Conference purposes only)
In case of accident or serious illness, if the school is unable to contact me, I hereby authorize the school to take my child to the physician, emergency room and/or to the relative or neighbor indicated below:
Doctor’s Name Phone Address
Neighbor’s or Relative’s Name Phone Address
14. I agree to see that this student’s tuition is cared for monthly.
15. I agree to cooperate with the school board and teachers by avoiding adverse criticism of any teacher or school policies in the presence of students.
16. I have read the school policy book and agree to support each regulation of the school, written and oral.
17. I hereby authorize the school to send, upon request, the permanent records to the next school to which my child may enroll.
18. ____________________________________________________________ (Signature of Parent or Guardian for the above #11 through #17 agreements)
Make copies for cumulative folder, principal and teacher
C:\Documents and Settings\Owner\My Documents\Red Book\Application for Admission.doc