5) Please give us the name of the last school attended and grade completed.
1) How did you hear about Paradise Christian School?
2) Reason for selecting Paradise Christian School?
3) Does your child have any disciplinary issues to be discussed? i.e. suspension, expulsion, substance abuse, juvenile or
arrest record. If YES, provide explanation below.
4) Has your child ever failed an academic subject? If YES, which subject(s) and at what grade level?
School:
6) Please tell us about your church attendance including name of church, name of pastor, and regularity of attendance? (Please
note that a letter of reference from your Pastor may be requested.)
Full Name:
First and Last Name
Birth Date:
xx/xx/xxxx
A copy of your child's immunization record is required upon admittance.
Applicant's Personal Information
Parents or Guardians
Full Name:
Relationship:
Address:
Home Phone:
Work Phone:
Mobile Phone:
Employer:
Full Name:
Relationship:
Address:
Home Phone:
Work Phone:
Mobile Phone:
Employer:
Other Emergency Contact
Full Name:
Relationship:
Home Phone:
Mobile Phone:
Work Phone:
Medical Information
Doctor:
Phone Number:
Urgent Care Provider:
Allergies, Medical Problems, or Medications:
- Press to clear the entire form.
- Press to submit completed form to Paradise Christian School Email.
A
B
Student
C
First and Last Name
Street, City, Zip Code
Grade:
First and Last Name
Street, City, Zip Code - or - same as above
First and Last Name
A copy of your child's birth certificate is required upon admittance.
T h a n k Y o u f o r y o u r i n t e r e s t i n P a r a d i s e C h r i s t i a n S c h o o l
Student Application
DATE:
