Student's Full Name *

Registration Fee Selection *

Enrollment *

Grade to Enter *

Do we need to request student records from another school? *

If so, which school?

Physical Address with city, state, and zip *

Age *

Date of Birth (month-day-year) *

Father's Name *

Father's Employer *

Employer's Phone Number *

Mother's Name *

Mother's Employer *

Employer's Phone Number *

Has your child ever failed a grade? *

If so, which grade?

Primary Email Address *

Additional Family Email Address (if applicable)

Students Email Address (if applicable)

Child's Physician *

Physicians Contact Info *

Church that the student is attending *

Pastor's Name *

Emergency Contact if parents cannot be reached (Name and Cell #) *

I understand and agree with the policies of Standish Baptist Academy, including those regarding discipline, finances, and church attendance. I give permission for my child to attend required activities off the school property. *