Napa Christian Student Application
Now accepting applications for the 2018-19 school year.
Student Information
Student Name *
Your answer
Entering Grade *
Referred by:
Your answer
Student Legal Name *
First Middle Last
Your answer
Preferred Nickname:
Your answer
Gender:
Age *
Your answer
Date of Birth: *
MM
/
DD
/
YYYY
Place of Birth: *
Please provide Proof of Birth to school for verification. (Birth Certificate, Passport, Notarized Statement, or Hospital Statement)
Your answer
Student's Email:
Your answer
Prominent Ethnic Background (for statistical purposes only):
Street Address
Your answer
City
Your answer
State:
Your answer
Zip Code:
Your answer
Is the student a baptized member of the Seventh-day Adventist Church?
If yes, date baptized:
MM
/
DD
/
YYYY
Church where membership is held:
Your answer
School last attended:
Your answer
Grade Level last year *
Former School Address
Your answer
Former School Phone Number
Your answer
Has this student been previously placed or recommended for a Special Education Program? *
If yes, please provide details:
Your answer
Does this student have an unpaid account at another school?
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