Online Application for Enrollment

 

First and Last Name Required

Student's Birth Date Required

Gender Required

HS Student's SSN

Applying for Humanities (y/n) Required

2011 - 2012 Grade Level Required

Campus desired: MP / WA / Col Required

Applying for Math (y/n)

Math course desired:

Applying for Science (y/n)

Science course desired:

Present or last school attended (note if homeschooled)

Parents Name Required

Address Required

Email Address Required

Phone Number Required

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Moms cell:

Dad's cell:

Father - Do you have a bachelor's degree? (y/n)

Mother - Do you have a bachelor's degree? (y/n)

In case of emergency contact (name - other than parent) Required

In case of emergency contact (phone) Required

To the best of your knowledge is the student a follower of Jesus Christ? (y/n)

Family Church Name:

Student's History: Please give a brief evaluation of the studnt's academic background and achievements.