WCA APPLICATION FOR STUDENT ENROLLMENT

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Please complete the following application and return with all of the enclosed forms, a copy of your child’s most recent report card, and standardized test scores if applicable, for enrollment consideration.

Today’s Date ________________ Applying for grade: ________________ School Year 20_______ / 20 ________

Applicant’s Full Legal Name : __________________ ___________________ _________________________ Boy ____ Girl ____

First Middle Last

SS # _________________________

Home Address ______________________________________________________________________________________________

Street and Number City State Zip

Birth Date ______/_____/_____ Age _________ Any grade repeated ? _________ Any grade skipped? _________

Has applicant ever been suspended ? ______ Has applicant ever been expelled ? _________ If yes to either, please explain:

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School currently attending _____________________________________________________________________________________

Name Address City / State Zip

School Phone number ( ____ ) _________________ Person receiving Teacher Reference form: _____________________________

Church currently attending _____________________________________________________________________________________

Name/ Denomination Address City / State Zip

Person receiving Pastoral Reference form: ________________________________________________________________________

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Parent / Guardian Information

Applicant lives with ( check all that apply ): ___ Father ___ Mother ___ Stepfather ___ Stepmother ___ Other/relationship_____

Check if appropriate: ______ Mother deceased ______ Father deceased ______ Parents separated ______ Parents divorced

If not living with both parents, who has legal custody? _______________________________________________________________

Father/ Guardian _________________________________ Mother / Guardian __________________________________

Home Address ___________________________________ Home Address _____________________________________

(if different from applicant’s) (if different from applicant’s)

________________________________________________ _________________________________________________

City State Zip City State Zip

Home Telephone ( ____) ___________________________ Home Telephone ( ____) ____________________________

Occupation / Position ______________________________ Occupation / Position _______________________________

Company _______________________________________ Company _________________________________________

Business Telephone (____ ) _________________________ Business Telephone (____ ) __________________________

Who referred you, or what was your source of information regarding WCA ? ____________________________________________

Briefly explain the reason for the applicant’s transfer to WCA. Use the back if necessary. _________________________________

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