2019-2020 Application
Admission to Beacon Academy is based on availability per grade. We will let you know as soon as possible if your child has been accepted for the 2019-2020 school year.
STUDENT(S) INFORMATION
Please provide student information for all students attending Beacon Academy
Last Name Student #1 *
Your answer
First Name Student #1 *
Your answer
Middle Name Student #1
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Applying for Grade *
Applying for Full Time/Part Time *
Is student a baptized Seventh-day Adventist church member? *
Is student a U.S. Citizen? *
Does student speak fluent English? *
How did you hear about our school?
Your answer
Last Name Student #2
Your answer
First Name Student #2
Your answer
Middle Name Student #2
Your answer
Date of Birth
MM
/
DD
/
YYYY
Applying for Grade
Applying for Full Time/Part Time *
Is student a baptized Seventh-day Adventist church member?
Is student a U.S. Citizen?
Does student speak fluent English?
Last Name Student #3
Your answer
First Name Student #3
Your answer
Middle Name Student #3
Your answer
Date of Birth
MM
/
DD
/
YYYY
Applying for Grade
Applying for Full Time/Part Time *
Is student a baptized Seventh-day Adventist church member?
Is student a U.S. Citizen?
Does student speak fluent English?
FAMILY DATA
Please provide parent information in this section
Mother's Last Name
Your answer
Mother's First Name
Your answer
Home Address
Your answer
Home Phone
Your answer
Cell Phone
Your answer
Business Phone
Your answer
Email Address
Your answer
Profession
Your answer
Name of Employer
Your answer
Member of as SDA Church
Primary Language Spoken
Country of Origin
Your answer
Father's Last Name
Your answer
Father's First Name
Your answer
Home Address
Your answer
Home Phone
Your answer
Cell Phone
Your answer
Business Phone
Your answer
Email Address
Your answer
Profession
Your answer
Name of Employer
Your answer
Member of SDA Church
Primary Language Spoken
Country of Origin
Your answer
STUDENT PICKUP AUTHORIZATION AND EMERGENCY CONTACTS
I give the following people permission to pick up my student(s) from school.
Name
Your answer
Relationship
Phone Number
Your answer
Name
Your answer
Relationship
Phone Number
Your answer
Name
Your answer
Relationship
Phone Number
Your answer
STUDENT EDUCATIONAL BACKGROUND
Previous schools attended
Your answer
Does the student have an unpaid school account?
Has the student been suspended, expelled, or asked to withdraw from any school?
Has the student ever undergone any type of professional counseling?
Has the student ever taken illegal drugs of any kind?
Does the student have any ongoing health problems or physical disabilities?
Has the student been tested for special learning needs, or recommended for tutoring?
If you answered “yes” to any of the questions in this section, please explain:
Your answer
CONSENT FOR MEDICAL TREATMENT
It is of utmost importance that this portion be filled out in its entirety.
Student's Physician
Your answer
Physician's Phone Number
Your answer
Health Insurance Company
Your answer
Policy #
Your answer
Is Student #1 currently taking any medications? If YES explain.
Your answer
Does Student #1 have any allergies? If YES explain.
Your answer
Is Student #2 currently taking any medications? If YES explain.
Your answer
Does Student #2 have any allergies? If YES explain.
Your answer
Is Student #3 currently taking any medications? If YES explain.
Your answer
Does Student #3 have any allergies? If YES explain.
Your answer
In the event that my child(ren) becomes ill or is injured while under school supervision, I approve the school authorities taking the following steps in the following order: 1. Contact a parent or legal guardian of the student and follow his or her instructions. 2. In the event of an emergency, when neither parent nor legal guardian can be reached immediately, the school authorities are hereby authorized to use their best judgment in contacting a properly licensed physician, or in transporting the student to the nearest hospital for consultation and/or treatment. It is understood that reasonable effort will be made to contact the doctor listed above before any other physician is called by the school or other organization. Transportation is to be done either by school provided transportation, or if school officials deem it wise, by ambulance. If, in the opinion of a properly licensed and practicing physician, the student needs medical or surgical services which require my consent before being supplied, and I cannot be reached, I hereby authorize, appoint, or empower the Principal or his designated representative, to furnish on my behalf such written or oral authorization as may be so required. Furthermore, I release the Principal, or her designated representative, and Beacon Academy from any liability which might arise from the giving of such authorization, it being my desire that the student be furnished with such medical or surgical services as soon as possible after the need arises. This consent shall remain in continuous effect until revoked in writing and delivered to the physician named above or to the school or organization entrusted with the custody of said minor. By selecting YES, NO, or OTHER you are agreeing to the above statement. *
FIELD TRIP PERMISSION
This permission slip will allow the child to participate in all school sponsored field trips. Additional information will be provided prior to each field trip regarding location, cost and any other pertinent facts. Parents/ Guardians who do not wish their student to participate in a particular trip may notify the teacher in writing or by phone.
I give permission for my child(ren) to go on field trips sponsored by Beacon Academy during the 2019-2020 school year. By selecting YES or NO you are agreeing to the above statement. *
TECHNOLOGY & ACCEPTABLE USE POLICY
Beacon Academy makes technology resources available to students to enhance their educational work at school. While the range of computer, telecommunication, and other technologies allows access to vast resources and information, it also places enormous responsibility on each student to use these systems in a considerate, ethical, and lawful manner. The use of these technologies is a privilege, not a right, and is subject to terms and conditions. Any user must adhere to the same code of ethics that governs all other aspects of life within the Beacon Academy community. Actions performed or initiated through the use of technology must reflect honesty, integrity, and compliance with the rules of conduct set forth in the Beacon Academy school handbook.

TERMS & CONDITIONS FOR TECHNOLOGY USE:
1. Technology use must be for educational endeavors only, in accordance with the principles of Adventist education. Personal use is permitted only with special permission. For example, students should not use the Internet for e-mailing or entering chat rooms unless it is part of an academic activity being used and monitored by an instructor.
2. The use of technology at Beacon Academy is a privilege, not a right. Inappropriate use will result in loss of the privilege.
3. Tapes and files belonging to others should not be accessed or used without permission.
4. Be polite. In all communication, use language appropriate for a positive school environment.
5. Users are responsible for reporting problems, abuses, or misuses of technology resources to a faculty member in a timely manner.
6. Students will be issued a Beaconacademy.us G Suite for Education email account to use for school purposes eg Google Classroom.
ACCEPTABLE INTERNET USE POLICY:
1. Do not share anyone’s personal information, such as pictures, name, address, phone number or email address, including your own.
2. Never email someone for the first time without your teacher’s permission.
3. Do not tamper with system security or interfere with another individual’s account.
4. Do not disrupt network use for others. This includes sending chain letters or any other type of communication that might cause a congestion of the Internet.
5. Vandalism of any sort will result in loss of privileges. This includes, but is not limited to, uploading, downloading, or creating a virus.
6. All communications and information accessible via the network should be assumed to be private property. Copyrighted materials may not be used without the permission of the author. Do not plagiarize; when using ideas or words that are not your own, cite the source of the information appropriately.
WARNING:
When using the system, you may feel you can easily break a rule and not get caught. This is not true. Electronic footprints are imprinted on the system whenever an action is performed. Therefore, you are likely to be caught if you break the rules.
GENERAL INFORMATION REGARDING COMPUTER USE:
1. The Internet is considered a limited forum, and therefore the school may restrict students’ right to free speech for valid educational reasons.
2. Privacy is not guaranteed for the contents of personal files on the school computers or Internet system. Routine maintenance and monitoring of the system may lead to discovery that this policy, the school code, or the law has been violated. An individual search will be conducted if there is reasonable suspicion that such a violation has occurred. The investigation will be reasonable and related to the suspected violation. Furthermore, teachers and parents have the right at any time to see the contents of a student’s computer-related files.
3. Beacon Academy will cooperate fully with local, state, or federal officials in any investigation related to illegal activities conducted through the system. In the event of a claim that a student has violated this policy, the school code, or the law in the use of the system, the student will be given written notice of suspected violations and an opportunity to present an explanation according to school code and/or state and federal law. Additional restrictions may be placed on computer and/or Internet use.
4. Beacon Academy makes no guarantee that the functions or the services provided by or through the system will be error-free or without defect. The school will not be responsible for any damage suffered including, but not limited to, loss of data or interruptions of service. The school is not responsible for the accuracy or quality of the information attained through or stored on the system. The school will not be responsible for financial obligations arising from unauthorized use of the system.



AGREEMENTS: Failure to abide by this policy may result in the suspension or loss of computer privileges, school disciplinary action, and/or appropriate legal action. I have read the above policies and fully understand them. I understand that employees of the school will make every reasonable effort to restrict access to all controversial material on the Internet, but I will not hold them responsible for materials the student acquires or sees as a result of the use of the Internet from school facilities. I give my permission to Beacon Academy to allow student(s) to use the Internet on computers at the school. *
PARENT/TEACHER CONCERN PROCEDURES
Beacon Academy has voted the following procedure for adoption for our school. The procedure is mindful of due process and founded on the Biblical principles of Matthew 18. Any questions regarding the fundamental philosophy and/or procedures prescribed should be directed to Administration.
1. Discuss the situation with your child’s teacher. All meetings with teacher(s) and/or principal must be by appointment.
2. If amiable agreement cannot be reached, a conference will be set up for the parent, teacher, and principal. The principal is to keep minutes of the meeting, including all relevant issues and/or agreements discussed. The minutes are to be reviewed by all parties prior to the completion of the meeting. Should the concern involve the school principal, the school board secretary would serve as the facilitator and keep minutes.
After having read the Parent/Teacher Concern procedure, I agree to follow the above guidelines while my child is enrolled at Beacon Academy. *
MEDIA RELEASE FORM
Beacon Academy regularly uses photos and video in its publications and materials. This form simply gives permission for images of the participant named to be used as outlined below.
For value received, I hereby consent and authorize Beacon Academy to use my name and/or the names of my family members who are minors, as listed below, as well as my likeness, photos, videos and other information (or that of family members who are minors) for the purpose of news releases, advertising, publicity, publication or distribution in all forms and media. I further consent to such use in their present form and to any changes, alterations, or additions thereto. I hereby release Beacon Academy from all liability in connection with all such uses. *
FINANCIAL POLICY & CONTRACT
Registration Fee (Full Time Students)
The non-refundable registration fee for each student is $400 and is due on or before registration, August 1, 2019. The registration fee helps cover the cost of instructional materials, technology fees, yearbook, student insurance, achievement tests, and other educational costs.

Registration Fee (Part Time Students)
The non-refundable registration fee for each student is $200 and is due on or before registration, August 1, 2019. The registration fee helps cover the cost of instructional materials, technology fees, student insurance, and other educational costs. Fees for achievement tests and yearbook will be extra.

Tuition—Tuition is due on or before the first of each month, and is payable on a ten-month basis, August through May. Tuition for August is due at registration time. A $30 late fee is charged when accounts are not paid in full by the close of the school day on the tenth of the month. A check returned because of insufficient funds will require a service charge of $30, which will be added to the next month’s statement. All accounts must be cleared before enrollment for the next school year can be accepted. If the account remains delinquent for more than 60 days, the account may be reported to a collection agency, and the student will be asked to stay home until the account is paid or a plan for payment is made with the treasurer. If a student is absent, withdraws, or is dismissed, no deduction or remission of a partial month’s tuition will be allowed.
We encourage full time students are able to pay the year’s tuition in advance. Doing so will result in a 5% discount on the total tuition for the year.

Full Time Part Time
Montessori $7,000.00 $4,300.00
1st-5th Grade $5,040.00 $2,520.00
6th-8th Grade $5,880.00 $2,940.00
9th-10th Grade $9,030.00 $4,515.00
I agree to the above Financial Policy *
CONDITIONS AND TERMS OF AGREEMENT
1. In making an application to Beacon Academy, parents/guardians should understand that the decision of the Admission Committee is made with the best interests of the student as the primary concern.
2. This application will not be considered until (a) this application has been filled out in full, (b) complete school records have been received, (c) reference forms have been received, (d) the student has taken a placement test, and (e) the student and his/her family has had a personal interview with the Principal.
3. All students must receive an acceptance notice before being considered officially enrolled.
4. Parents/Guardians are responsible for any additional charges/fees such as field trips, -shirts, field trip school pictures.
5. A vital part of Beacon Academy’s mission is the development of character and social responsibility. Conduct or attitudes, which the faculty and administration consider seriously detrimental to other students or to the school, may be considered grounds for dismissal.
6. A student’s success and happiness in the school environment depends greatly upon positive parental/guardian support of school policies. Our teachers, administrators, and programs all work together to provide a safe and pleasant environment. Your cooperation, support, and involvement in Christian education are an investment in your child’s future.
To the best of our knowledge, the information contained in this application is true and accurate. If any of this information is found to be false or misleading, the student is subject to dismissal. We have received and read through the Beacon Academy Handbook and will support Beacon Academy in all areas of school life. *
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