Application for Student Enrollment, Central Iowa Christian School
Welcome! Deciding how to educate your child is an important decision for your child's future and for your family.

Complete the following application for consideration to be enrolled at Central Iowa Christian School.
Name of child *
Your answer
Gender *
Grade entering *
Age *
Your answer
Will your child be full time or part time? *
Date of Birth *
MM
/
DD
/
YYYY
Place of Birth
Your answer
List any disabilities and/or special needs your child has *
Your answer
Past Record of Child's Education *
School, City/State, Years attended
Your answer
Has your child ever been dismissed from school for behavior problems? *
Has your child ever been dismissed from school for poor work/effort? *
How would you rate your child's scholastic ability? *
Is your child accustomed to bible reading and prayer in the home? *
Father's Information
Father's Name *
Your answer
Father's Occupation *
Your answer
Father's Address
Your answer
Father's Telephone Number
(xxx) xxx-xxxx
Your answer
Father's Email Address
Your answer
Mother's Information
Mother's Name *
Your answer
Mother's Occupation *
Your answer
Mother's Address
if different father's address listed above
Your answer
Mother's Telephone Number
Your answer
Mother's Email Address
Your answer
Marital Status of Parents
Siblings
Please list siblings from oldest to youngest. *
Name, Age, Grade, Where enrolled for school
Your answer
Are all of your school-age children being registered at CICS? *
If not all of your school-age children are being registered at CICS, please explain why. *
Your answer
Church Information
You do not have to be a Christian to attend CICS, though we have a statement of faith or openness to faith-teachings to which all families must agree.
Church Affiliation *
Your answer
Are you a member of this church?
Do you attend regularly?
Are you active in this church?
Why do you wish to enroll your child at CICS? *
Your answer
How did you hear about CICS? *
Required
Were you referred by a CICS family? If so, who? *
Your answer
Do you anticipate the need for tuition assistance? *
Tuition assistance will be granted if funds are available and only up to 40% of the cost of tuition.
To keep tuition costs down and build community, parents are expected to be active in the school, including volunteering for various events and fundraisers. We ask for no less than 10 volunteer hours per family per child. Are you prepared to meet these expectations? *
Is there any additional information you feel we should know in considering this application?
Your answer
Thank you for your submission!
Your application cannot be considered until we receive your $25 application fee. Please mail or drop off a check to continue the application process. The application fee is non-refundable.

During the application process, you may be contacted by a CICS board member to set up an interview.

Upon acceptance, you will be notified by a school board member.

Central Iowa Christian School
201 380th Avenue
Grinnell, IA 50112
641-236-3000
cics@centraliowachristianschool.org
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