APPLICATION FORM FOR NEW STUDENTS
STUDENT INFORMATION
Student’s Legal Name (Last) *
Student’s Legal Name (First) *
Student’s Legal Name (Middle) *
Preferred Name
Applying for what grade? *
Desired Starting Date: *
If fall start date, list year:
Student's Email *
Parent’s Primary Phone *
Alternate Phone
Student’s Cell
Mailing Address *
City *
State *
Zip *
Student’s Birthdate *
Place of Birth (City, State, Country) *
Gender *
Race
Clear selection
Last School Attended *
Grade *
School Address
Has this student previously applied to or attended SC? *
If yes, list grades:
PARENT/GUARDIAN INFORMATION
Please advise us of your family situation so that we can best serve you.
*
If applicable, which household is the student’s primary residence?
Parent Name (1) *
Relation *
Address (If different from applicant)
Cell *
Email *
Occupation (Position) *
Occupation (Name of Employer or Business) *
Did you attend SC? *
If Yes, Grad Year
If Yes, Name at Graduation
Parent Name (2)
Relation
Clear selection
Address (If different from applicant)
Cell
Email
Occupation (Position)
Occupation (Name of Employer or Business)
Did you attend SC?
Clear selection
If Yes, Name at Graduation
If Yes, Grad Year
If Yes, Name at Graduation
Does this student have any siblings who will/does/did attend Santiam Christian?
List Name(s) & Grade
SPIRITUAL INFORMATION
Are you currently attending a church?
Clear selection
Name of Church Attending *
Pastor *
Are you a Christian? *
Father:
Are you a Christian? *
Mother:
Please describe what it means to be a Christian *
1. How do you provide spiritual training for children in the home? *
2. What goals do you have in mind for the training and development of your child(ren) as individuals? *
3. What are your reasons for wanting them to enroll in Santiam Christian at this time? *
SCHOLASTIC INFORMATION
Has student ever been suspended, dismissed or refused admission to another school? *
If Yes, please explain:
Is this student on an IEP or 504 plan? *
Did student have any disciplinary problems in his/her previous school? *
If Yes, please explain:
Has student ever skipped a grade? *
If “Yes”, which one?
Has student ever repeated a grade? *
If “Yes”, which one?
When calling your previous school, what comments could we anticipate *
Additional Comments:
MEDICAL INFORMATION
Does this student have any physical disabilities: *
If "Yes" please explain
Are there any diagnosed learning disabilities such as dyslexia, ADHD, etc., that require special treatment and/or programs? *
Is your student currently taking any regular medication? *
If "Yes" explain:
Is there anything else we should know in order for us to better serve your student?
FINANCIAL INFORMATION
By checking this box I understand that the Financial Aid Application is separate. *
This application for enrollment does NOT access the SC financial aid program. If aid is required for your enrollment, please follow the financial aid application instructions on the Santiam Christian website.
Required
Santiam Christian is a tuition driven system in which 85% of our income comes from student tuition and fees. 15% of our funds come through gifts and fund raisers. According to the enclosed tuition schedule, can you pay the full tuition and fees for this student? *
If no, what is the maximum amount you can pay per month?
FAMILY REFERENCES
Please list three (3) references who know your family well.
Reference Name (1) *
Address *
Phone *
Reference Name (2) *
Address *
Phone *
Reference Name (3) *
Address *
Phone *
We hereby certify that the above answers are true and are made with no reservations beyond those in the attached explanations. *
Father / Mother / Guardian Signature
Date *
REFERRAL VERIFICATION
If you were referred to SC by a specific family, please indicate here: Name of Referring Family:
STATEMENT OF FAITH
1. We believe the Bible to be the inspired, the only infallible, authoritative, inerrant Word of God (II Timothy 3:16, II Peter 1:21).

2. We believe there is one God, eternally existent in three persons - Father, Son, and Holy Spirit (Genesis 1:1, Matthew 28:19, John 10:30).

3. We believe in the deity of Christ (John 10:33); His virgin birth (Isaiah 7:14, Matthew 1:23, Luke 1:35); His sinless life (Hebrews 4:15, Hebrews 7:26); His miracles (John 2:11); His vicarious and atoning death (I Corinthians 15:3, Ephesians 1:7, Hebrews 2:9); His resurrection (John 11:25, I Corinthians 15:4); His ascension to the right hand of the Father (Mark 16:19); His personal return in power and glory (Acts 1:11, Revelation 19:11).

4. We believe in the absolute necessity of regeneration by the Holy Spirit for salvation because of the exceeding sinfulness of human nature; and that men are justified on the single ground of faith in the shed blood of Christ and that only by God's grace, through faith, are we saved (John 3:16-21, John 5:24, Romans 3:23, Romans 5:8-9, Ephesians 2:8-10, Titus 3:5).

5. We believe in the resurrection of both the saved and the lost; the saved unto the resurrection of life, and the lost unto the resurrection of damnation. (John 5:28-29).

6. We believe in the spiritual unity of believers in our Lord Jesus Christ (Romans 8:9, I Corinthians 12:12-13, Galatians 3:26-28).

7. We believe in the present ministry of the Holy Spirit by whose indwelling the Christian is enabled to live a godly life (Romans 8:13-14, I Corinthians 3:16, I Corinthians 6:19-20, Ephesians 4:30, 5:18).
I agree to support Santiam Christian’s statement of Faith and I understand that this Statement of Faith is the foundation of all instruction at Santiam Christian Schools. *
(At least one Custodial Parent or Guardian must sign this page.)
Father / Mother / Guardian Signature *
Date *
COMMENTS (Optional):
PARENTAL COVENANT
Santiam Christian School’s educational mission and Biblical role is to work in partnership with the home to provide Christian education designed to mold students to become Christ-like. On occasion this cooperation between the school and home may become difficult or strained. It may be that the atmosphere or conduct within a particular home may even be in opposition to the Biblical lifestyle that the school teaches. To avoid such situations, the school requires parents enrolling their children, or to maintain enrollment, to affirmatively support and cooperate with the school. No student will be accepted into the school unless their parents sign, without any reservations, the agreement written below:

As parents/guardian, I/we have read and do hereby acknowledge and understand that the following are working presuppositions by which Santiam Christian School is organized and operated:

1. I agree to support the school with my prayers and with a positive attitude. Complaints or negative comments will be shared only with the teacher, administrator, or person involved and not with my child or other people, following the Matthew 18 principle.

2. Although children of many Christian denominations make up the Santiam Christian School student body, each student (and parent) enters with the awareness that all teaching will be based upon the Santiam Christian Schools’ Statement of Faith.

3. Santiam Christian School accepts the doctrine of "in loco parentis" (or in the place of the parents). We emphatically view the school, home, and local church as a partnership with its primary function of assisting the parents in fulfilling their responsibility to "train up their children in the way they are to go." (Prov. 22:6) I/We understand that this includes permission: a) to discipline as deemed wise and expedient for my child; b) to counsel my child Biblically; c) to be counseled Biblically when matters of my child's welfare arise. (Prov. 13:24; 19:18; 29:15, 17; Eph. 6:1-2; Heb. 12:6).

4. We pledge our fullest cooperation to keep doctrinal controversy and denominationalism out of the school at all times. (Rom. 13:8-10; I Cor. 12:12-14; 13:1-13; Gal. 5:13-15, 25-26).

5. If our son/daughter is involved in any disciplinary action, or should become involved in any trouble with other students, or should a misunderstanding arise between my student and the teacher, we will endeavor to settle any grievances quickly at the lowest level and according to Scriptural principles (Matt. 18, Gal. 6).

6. Assessments will be made to cover damage to school property (including breakage of windows, abuse of books, etc.)

7. A child who persists in undesirable conduct or attitude will not be permitted to remain in school to harm others by his influence. I/We further understand that the standards of the school do not tolerate profanity or obscenity by word or action, disrespect to school personnel, or abuse of building facilities.

8. We agree to pay tuition according to the schedule or to other arrangements that shall be made. I/We understand that report cards may be withheld if required payments are not made or arranged for. I/We also understand that if my account is 60 days past due, and no arrangements have been made, my child will no longer be able to attend Santiam Christian.

9. To help my child with homework when necessary and cooperate with the academic and spiritual goals of the school.

10. I understand that if at any time the school determines, in its sole discretion, that my actions as an individual or parent do not support the ministry, or reflect a lack of cooperation and commitment to the home and school working together, the school has the right to refuse admission of a new applicant or to discontinue enrollment of a current student.

I have read the above Parental Covenant and fully understand and agree to abide by its conditions.
Student's Full Name *
Father / Mother / Guardian Signature *
Date *
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