FCA HOMESCHOOL APPLICATION

 
STUDENT INFORMATION                                          SCHOOL YEAR: _______



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   LAST NAME                         FIRST                              MIDDLE                 AGE          SEX

 

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   ADDRESS                     STREET                          TOWN                     STATE             ZIP

 

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   BIRTHDATE                 BIRTHPLACE               SEX             PHONE NUMER (AREA CODE)

 

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   PARENT’S EMAIL                                                                      STUDENT’S EMAIL (IF ANY)

 

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   GRADE LAST ATTENDED                                         GRADE REPEATED (IF ANY)

 

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   SCHOOL ATTENDED DURING PRESENT OR PREVIOUS YEAR ADDRESS OF SCHOOL

 

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   FATHER’S NAME                                                                    MOTHER’S NAME

 

Indicate which payment method you will use for this school year: ___________
(Pay in Full; 10 Month Plan; 5 Month Plan)

 

Are you interested in purchasing used books if available?  (Yes or No) _____

 

 

In making this application,

1. As the parent or guardian of the above student, I understand the compulsory school laws of the state in which I reside and I accept full responsibility for my child’s enrollment with Faith Christian Academy for the purpose of homeschooling my child.

2. Those students who do not submit any course work over a period of two calendar months are dropped from the homeschool program and given a grade of W (Withdrawn) for each uncompleted course.

3. If I decide to pay my bill with month payments, the payments are due by the tenth of the month. A $25.00 late charge will be added to my account after the tenth of the month. If I miss two payments, my lessons will be terminated and I will be given a W (Withdrawn) for each course.

4. The school reserves the right to require the withdrawal of any student whose academic performance indicates an inability or unwillingness to meet the requirements of the school.

Signature of both parents is preferred, but one will be accepted.

 

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   Mother’s Signature                                                                 Father’s Signature