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New Student Enrollment Application

Welcome to Alpine Christian School! We are excited that you have interest in our school and ready to take the first step in completing an application for your child. Below you will find our New Student Application form that you can quickly complete. Once your application is received, our Admissions Committee will be in touch to discuss the next steps in the process. We select based on parent and student commitment to excel in all disciplines. We also encourage you to review our Statement of Faith and Parent Student Handbook.

Student Information - Step 1 of 7

Student's Name *

First

Last

Preferred Name

Grade applying for

Bridge K
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th-12th Grade

Student's Date of Birth *

How did you hear about us? (Please list who referred you, if applicable) *

Who should we contact regarding this application? *

Best Contact Phone Number

Best Contact Email Address *

Street Address *

City *

State *

Zip Code *

Student Home Phone *

Student's Gender *

Student's Ethnicity *

Student Citizenship *

Primary Language Spoken at Home *

Is your child potty-trained?

Can your child tell you his/her name?

Can your child tell you his/her age?

Can your child count to 10?

Can your child identify colors?

Can your child recognize basic shapes?

Does your child have any knowledge of the alphabet?

Does your child speak in complete sentences?

Is your child difficult to understand when he/she speaks?

Does your child verbally express his/her needs?

Can your child understand and follow simple directions?

Does your child have any other difficulties speaking?

Does your child seek opportunities to play with other children?

Does your child play cooperatively with other children?

Does your child play enjoy coloring, scribbling, drawing, or writing?

Does your child have temper tantrums?

How are temper tantrums handled?

How do you discipline at home?

How does your child demonstrate anger?

What upsets your child?

What makes your child happy?

What are your child's interests or hobbies?

How would you describe your child's personality?

Can your child use a spoon/fork to feed himself/herself independently?

Can your child dress himself/herself independently, except shoes?

Can your child put together simple puzzles independently?

Can your child manipulate scissors with one hand?

Can your child hold a pencil/crayon to write or draw a picture?

Does your child walk and run without difficulty?

Can your child sit quietly on the floor while being read to?

Choose Student's Interests

Art Class
Piano
Chess Club
Cooking
Gardening
Speech/Debate
Soccer
Basketball
Volleyball
Running
Hiking

Has your child ever been suspended or expelled from any school for any reason? *

Please explain.

Has your child ever been withdrawn from any school for any reason? *

Please explain.

Has your child ever been written up for discipline or behavior? *

Please explain.

Is your child currently working with a psychologist or therapist? *

Has your child ever repeated a grade? *

Please explain.

Has your child ever attended a school or participated in a program designed for students who have special academic needs or abilities? (Gifted, special education, resource, etc.) *

What programs?

Has your child received any special award(s) and/or recognition? (Not limited to school) *

What awards or recognition did they receive?

Has your child ever been diagnosed with a learning disability or dyslexia? *

Does your child take any medication in relation to the learning disability? *

Has your child taken any assessment tests in the past 8 months?

What assessments did they take?

Caregiver #1 Name *

First

Last

Caregiver #1 Gender *

Relationship to Applicant *

Custodial Rights? *

Have you ever been diagnosed with dyslexia? *

Financial Responsibility?

Religious Affiliation *

Church you currently attend? *

Marital Status *

Email *

Cell Phone *

Work Phone

Employer's Name *

Occupation

Employer's Street Address

Are you interested in volunteering in the classroom or with after-school activities?

Do you have any talents or skills you could share with our school or students?

Caregiver #2 Name

First

Last

Caregiver #2 Gender

Relationship to Applicant

Custodial Rights?

Have you ever been diagnosed with dyslexia?

Financial Responsibility?

Marital Status

Religious Affiliation

Church you currently attend?

Cell Phone

Work Phone

Employer's Name

Occupation

Employer's Street Address

Are you interested in volunteering in the classroom or with after-school activities?

Do you have any talents or skills you could share with our school or students?

Does the applicant have a parent/guardian that lives at another address?

Sibling #1

First

Last

Date of Birth

Sibling #2

First

Last

Date of Birth

Sibling #3

First

Last

Date of Birth

Does the applicant have any other relatives who currently attend, have attended, or have graduated from our school?

Do you plan to apply for tuition assistance? *

Will your child need before-school or after-school childcare? *

Do you intend for this to be short-term or long-term placement? *

Short-Term
Long-Term

What examples best describe your child's strengths? *

What examples best describe your child's areas of needed improvement? *

How do these strengths and weaknesses affect their performance in the classroom?

Any additional comments you would like for ACS to consider? *

The electronic signature below and their related fields are treated by Alpine Christian School like a physical handwritten signature on a paper form. My signature affirms that to the best of my knowledge the information in this application is accurate. I also understand misrepresentation could invalidate the application process. *

Check for electronic signature

Name: *

Date / Time *

Date

Time

Check for electronic signature

Name:

Date / Time

Date

Time

Name

New Student Enrollment Application

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(432) 837-5757