Date of Application
Grade Level Student is Entering
3-year-old (M-W-F 8:45-11:00)
3-year-old (Tu-Th 8:45-11:00)
Pre-Kindergarten (M-F 8:45-11:15)
Pre-Kindergarten (M-F 12:30-3:30)
Kindergarten
First
Second
Third
Fourth
Fifth
Sixth
Seventh
Eighth
How did you learn about RCS?
If you were referred by an RCS family, please list family name(s)
Information About This Child - General
First Name
Middle Name
Last Name
Nickname/Preferred Name
SSN
Race (optional)
African-American
Caucasian
American Indian
Hispanic
Asian
Other
Home Address
City
Zip
Date of Baptism
Church Where Baptized
Name of Church
Church Phone
Pastor's Name
Information About This Child - Previous School(s) Attended
Please note: Previous schools may be contacted during the admissions process.
Preschool
Preschool1 Name
Preschool1 Address
Preschool1 Dates Attended
Preschool
Preschool2 Name
Preschool2 Address
Preschool2 Dates Attended
Kindergarten
Kindergarten1 Name
Kindergarten1 Address
Kindergarten1 Dates Attended
Kindergarten
Kindergarten2 Name
Kindergarten2 Address
Kindergarten2 Dates Attended
Elementary Grades
Elementary1 Name
Elementary1 Address
Elementary1 Dates Attended
Elementary
Elementary2 Name
Elementary2 Address
Elementary2 Dates Attended
Information About This Child - Additional
Describe special education services received by the student (if any).
Explain discipline or behavioral concerns about which the school should be aware.
Why would you like this child to attend Redeemer Christian School?
If this application is for the elementary grades, please attach copies of the student's most recent standardized test results (e.g., achievement test) and most recent report card and/or other school evaluation.
We will also need current shot records upon acceptance of your child to RCS.
Information About Siblings and Household
Sibling 1 First & Last Name
Sibling 1 Age/Grade
Sibling 1 School Attending (if any)
Sibling 2 First & Last Name
Sibling 2 Age/Grade
Sibling 2 School Attending (if any)
Sibling 3 First & Last Name
Sibling 3 Age/Grade
Sibling 3 School Attending (if any)
Sibling 4 First & Last Name
Sibling 4 Age/Grade
Sibling 4 School Attending (if any)
Sibling 5 First & Last Name
Sibling 5 Age/Grade
Sibling 5 School Attending (if any)
(please explain if "Other")
(please explain if "Other")
Describe custodial arangements if natural parents are not in the same household.
Please provide a copy of the custodial agreement.
Note of Non-Discrimination
Information About the Natural/Legal FATHER of the Student
Legal Name
First
Middle
Last
Nickname/Preferred Name
Email Address
Home Phone (if different from student)
Cell Phone
Work Phone
Home Address (if different from student)
Place of Work
Work Address
Name of church currently attending (if any)
Information About the Natural/Legal MOTHER of the Student
Legal Name
First
Middle
Last
Nickname/Preferred Name
Email Address
Home Phone (if different from student)
Cell Phone
Work Phone
Home Address (if different from student)
Place of Work
Work Address
Name of church currently attending (if any)
Information About Other Adults (Stepparent, Legal Guardian)
Legal Name
First
Middle
Last
Nickname/Preferred Name
Email Address
Home Phone (if different from student)
Cell Phone
Work Phone
Home Address (if different from student)
Place of Work
Work Address
Name of church currently attending (if any)
Final Consent
Please check the boxes below to affirm your agreement.
SUBMIT