Charleston Seventh-day Adventist School

New Application

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New Application
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Charleston SDA School
2518 Savannah Highway
 Charleston, SC 49414
 
Please share with us
How did you hear about Charleston SDA School? (Please circle one):
Current Charleston SDA School family              Drive-by             Friend             Advertisement
Other: ____________________________________________________________________________
 
Student Name and Family Information
I am applying for ____ grade, beginning   Fall ____ Winter ____   of 20 ___
 
Applicant’s Name: ________________________________________________________________
                                           First                                 Middle Initial                                 Last                                                        
 
Goes by: _______________________________    Male _____         Female _____
 
Social Security #: ________________________    Date of Birth:   _____________
 
(Make SS Card, birth certificate, & immunization available for copying)  Place of Birth _____________
 
Father’s Name: __________________________    Mother’s Name: _________________________
                                         First                       Last                                                                              First                        Last
Street Address: _____________________________________________________________________
 
City: __________________________      State: __________________     Zip: ___________________
 
Home Phone: ___________________________ Email ___________________________________
 
Father’s Occupation: ______________   Business Phone: __________ Cell Phone: ____________
Years of Education ___________ Birth Place __________________ Birth Date _______________
US Citizen? ____ Marital Status ________SS# _____________other Email _________________
Mother’s Occupation: _____________ Business Phone: __________ Cell Phone: ____________
Years of Education ___________ Birth Place __________________ Birth Date _______________
US Citizen? ____ Marital Status ________SS# _____________other Email _________________
 
Check if appropriate:
_____ Father deceased _____ Mother deceased _____ Parents divorced
_____ Parents separated _____ Father remarried _____ Mother remarried
Please list child’s secondary household:
 
Name: ______________________________________ Relation: _______________
                                First                                       Last
Street Address: ____________________________________________________________________________
 
City: ___________________________ State: ___________________ Zip: _____________________
 
Home Phone: ____________________ Email ___________________________________________
 
Occupation: _____________________ Business Phone: ___________ Cell Phone: ______________
 
Church Affiliation
Name of Church _______________________________ Years Attended: ______
Pastor’s Name _____________________________                   Phone Number ________________
Do you and your child actively attend church regularly?    Yes _____ No _____
Is applicant an Adventist Church Member?         Yes ___ No ___      
Father a member? Yes ___ No ___ Mother a member? Yes ___ No ___
 
Education Information
 
Present School _______________________________        Dates Enrolled: ____________________
 
Phone Number: _______________________________
 
Present Teacher _______________________________
 
Has applicant ever skipped a grade? _______________
 
Has applicant ever been retained? _________________
 
Has applicant ever been suspended or expelled form school for any reason? ___________________
 
If yes on any questions above, please explain: ___________________________________________
 
___________________________________________________________________________________________
 
___________________________________________________________________________________________
 
If the applicant has a disability and would like to request accommodations in the admission process, please explain here. Documents from a qualified professional should either be enclosed with this application or sent directly to the school office: ___________________________________________
___________________________________________________________________________________________
 
___________________________________________________________________________________________
 
Does the applicant require any medication? _____________ If yes please explain: _______________
 
___________________________________________________________________________________________
 
Check here _____ I understand a current physical exam will be submitted to complete registration.
 
Parent Testimony
 
Please give a brief description of your faith in Christ, when you came to know the Lord, evidences of your spiritual growth, etc:
 
 
 
 
 
 
 
 
 
Please give a brief summary of your expectation of Christian education, to include your reasons for applying your child in Charleston SDA School:
 
 
 
 
 
 
 
 
Application must be complete and received with appropriate fees in order be processed. A completed application does not guarantee acceptance. The CSDAS School Committee makes final decisions.