Livingston Christian Schools Application for Enrollment

Student Information
Student's Last Name *
Your answer
Student's First Name *
Your answer
M/F *
Date of Birth *
MM
/
DD
/
YYYY
Previous School *
most recent if more than one
Your answer
Applying for Grade: *
Street Address *
Your answer
City *
Your answer
Zip *
Your answer
School district in which you reside: *
Your answer
Church Home *
Your answer
Pastor's Name *
Your answer
Does this child attend church regularly? *
Has this child accepted Jesus Christ as Savior and Lord? *
Do you provide spiritual encouragement for your child through devotional times at home? *
Please list any hobbies and/or special interests of the child *
Your answer
Father's Information
Father's Last Name *
Your answer
Father's First Name *
Your answer
Father's Street Address *
if same as students you may enter "same"
Your answer
Father's City *
if same as students you may enter "same"
Your answer
Father's Zip *
if same as students you may enter "same"
Your answer
Father's Phone # *
Your answer
Father's Email *
Your answer
Father's Marital Status *
Father's Employer & Position *
Your answer
Father's Church *
if same as students you may enter "same"
Your answer
Do you attend regularly? *
Have you (father) personally accepted Jesus Christ as Savior and Lord? *
Mother's Information
Mother's Last Name *
Your answer
Mother's First Name *
Your answer
Mother's Street Address *
if same as students you may enter "same"
Your answer
Mother's City *
if same as students you may enter "same"
Your answer
Mother's Zip *
if same as students you may enter "same"
Your answer
Mother's Phone # *
Your answer
Mother's Email *
Your answer
Mother's Marital Status *
Mother's Employer & Position *
Your answer
Mother's Church *
if same as students you may enter "same"
Your answer
Do you attend regularly? *
Have you (mother) personally accepted Jesus Christ as Savior and Lord? *
Admission Information
How did you hear about LCS? *
Why do you wish to enroll your child in LCS? *
Your answer
Why do you want to attend LCS?
this question to be completed by students applying for grades 7-12
Your answer
Has your child attended another Christian or private school at any time in the past (including current year)? *
If yes to above question, were you requested to remove or withdraw your child for any reason?
If yes to above question, please explain
Your answer
If your child has had any behavior problems in a previous school or been suspended from or denied enrollment from any school, please explain
Your answer
If your child has ever repeated or skipped a grade, what grade?
Your answer
Does your child have any special needs that require professional attention? *
Does your child have a learning disability? *
Has your child ever been in a special education program or classroom? *
If yes to above questions, please explain
Your answer
Does your child have any special medical conditions (illnesses, allergies to drugs, etc.) about which the school should know? *
If yes to above questions, please explain
Your answer
In submitting this application, I (we) acknowledge that: *
Required
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