ST.

JOSEPH CHRISTIAN SCHOOL Application for Admission 2011/2012

Elementary: 5401 Gene Field Road Secondary: 5401B Gene Field Road
St. Joseph, MO 64506 St. Joseph, MO 64506
816.279.1555 FAX: 816.279.4574 816.279.3760 FAX: 816.279.3836
www.stjosephchristian.com Date Received__________________

Student’s Legal Name __________________________________ DOB ____/____/____ SS#_____-____-_____

Entry Grade at SJCS_______ Pre-K preference: AM, PM, either (Circle one)

Admission to St. Joseph Christian School is based upon a personal interview with parents (and personal interview with student 7–12),
this application, student test results, and other academic/spiritual input.
Due to a lack of specialized services, SJCS cannot enroll students whose special education needs cannot be met in the present program.
Students and parents are expected to adhere to St. Joseph Christian School's "General Behavior Expectation" or “Student Conduct” as
stated in the SJCS Student Handbook or found on the website: www.stjosephchristian.com. St. Joseph Christian School reserves the right
to deny admission to any applicant.
St. Joseph Christian School does not discriminate on the basis of race, color, or national or ethnic origin in the administration of its
educational policies, admissions policies, sponsorship programs, athletic programs, and other school-administered programs.

Name/address of custodial parent(s):

Father Mother
Mr._________________________________________ Ms./Mrs. (circle)________________________________
Address_____________________________________ Address______________________________________
City, State_____________________ Zip___________ City, State_______________________ Zip __________
Home phone_________________________________ Home phone___________________________________
Cell phone __________________________________ Cell phone ____________________________________
Email ______________________________________ Email ________________________________________
Occupation __________________________________ Occupation ___________________________________
Employer____________________________________ Employer _____________________________________
Business phone_______________________________ Business phone ________________________________
Do you attend church? ________________________ Do you attend church_________________________
How often? __________________________________ How often? ___________________________________
Church name ________________________________ Church name__________________________________
Address_____________________________________ Address _____________________________________
City, State____________________ Zip ___________ City, State _______________________Zip__________
Pastor's name________________________________ Pastor's name_________________________________
Do any of the following apply? Do any of the following apply?
Widow/er Separated Separated

Is child by present marriage? _____________ Is child by present marriage? ____________

If child is not living with his/her natural mother and
father, please explain the present home situation.
_________________________________________
_________________________________________
_________________________________________
_________________________________________
_________________________________________
_________________________________________
Non-custodial parent does/does not (circle) wish to
receive school communications (newsletter, etc.).
Non-custodial parent information (if applicable):
Name ________________________________________
Address ______________________________________
City, State_________________________ Zip_________
Home phone___________________________________
Cell phone____________________________________
Email ________________________________________
Occupation ___________________________________
Employer _____________________________________
Business phone ________________________________
Please list other children and other persons living with the family.

Name Relationship Birthday (month, day, year)

Names of other children enrolled at St. Joseph Christian School: _________________________________

Has the student previously applied to or attended (circle one) SJCS? If yes, give year:_______

Please list schools attended during the last three years:

School Address, City, State, Zip Grades

Which public school would your child have attended? ___________________________________________

Has the student ever been suspended? expelled? asked to withdraw? (circle)
If yes to any, please give full particulars on a separate sheet of paper, including the principal's name and the
school's name and address.

Did previous school request parent conference to discuss discipline matter during the past year? _________
If so, please explain the situation on separate sheet of paper.

Did previous school suggest testing for a learning concern? ______ Modify classroom expectations in anyway?
______ If so, please explain on a separate sheet of paper.

Does student have any learning concerns that might limit him/her, such as:
Dyslexia Yes No
Hand-eye coordination Yes No
ADD/ADHD Yes No
Learning disability Yes No
Others____________________________________________________________
If yes to any of the above, please explain on separate sheet of paper.

Does the student have a physical, emotional, or mental disability that may affect his/her schooling? ____
If yes, please explain on a separate sheet of paper.

Briefly describe the student's extracurricular interests and abilities:

_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
 In signing this application, we give permission for our child to participate in all school activities including sports
and school-sponsored trips away from the school premises (except as specifically listed below). Further, if our
child becomes ill or is injured while under school supervision, we permit school authorities to take the following
steps:
 Contact a parent of the student and follow his/her instructions.
 In the event neither parent can be reached, contact the student's physician and follow his instructions.
 If the student's physician cannot be reached, the school authorities will use their own discretion in
contacting a properly licensed practicing physician and follow his instructions.

We agree to relieve SJCS, its school board, and any of its employees from any liability in connection with these
activities and instructions. Exceptions (if any): _____________________________________________________

In signing this application, we acknowledge the following:

SJCS STATEMENT OF FAITH

THE WORD OF GOD
The Word of God, in both the Old and New Testaments, is inerrant as originally given. It is inspired by God, and it is the
complete revelation of Himself to man. It is the consistent, only word of God (2 Timothy 3:16–17; 2 Peter 1:20–21; Revelation 22:18–
19).
GOD
There is one and only one living God. He is infinitely perfect, existing eternally in three persons: Father, Son, and Holy Spirit (1
Timothy 1:17; Matthew 28:19; Mark 1:10–11).
JESUS CHRIST
Jesus Christ is the eternal, only Son of God, who was conceived by the Holy Spirit and born of a virgin birth. Jesus is truly God
and truly man. He died on the cross as a substitutionary sacrifice. All who believe in Jesus by faith are justified on the basis of His
shed blood on the cross. Jesus died and physically rose again after three days and ascended into heaven where He is exalted at the
right hand of the Father. He will physically return to judge the world and establish His kingdom (John 1:1–3; Isaiah 7:14; Matthew
1:18; 1 Corinthians 15:3–4; 1 Timothy 1:15–17).
THE HOLY SPIRIT
The Holy Spirit is sent to indwell, guide, teach, and empower believers. The Holy Spirit convicts the world of sin,
righteousness, and judgment (Acts 2:38; Ephesians 1:13–14; 1 Corinthians 6:19; John 16:7–8).
MANKIND
Mankind was originally created without sin and in the image and likeness of God. He sinned through disobedience and
incurred physical and spiritual death. The eternal soul of a man is given at conception, and as eternal, will experience either eternal
life in heaven or eternal death in hell, based upon one's relationship with Christ (Genesis 1:26–27; Psalm 139:13–16; Jeremiah 1:5;
Romans 3:23; Revelation 20:10–15; 1 John 5:11–12).
SALVATION
Salvation has been provided through the death and resurrection of Jesus Christ for all who by faith believe in Him as Savior.
All who personally accept Him as Savior are born again and receive the Holy Spirit, the gift of eternal life, and become children of God
(John 1:14–18; 1 Corinthians 15:3–4; Ephesians 2:8–9; 1 John 5:9–13; John 1:12).

 Our commitment to the statement of faith of St. Joseph Christian School.

 Our commitment to the "General Behavior Expectation" or “Student Conduct” as stated in the Parent-
Student Handbook (on the website at: www.stjosephchristian.com) and to the policies and procedures of
SJCS.
 Our commitment to volunteer and log a minimum of twenty hours per year at SJCS.
 Our commitment to follow the “Matthew 18 Principle.” If our child(ren) should become involved in any
trouble, or we disagree with any policy set by the school, we will not complain to any other party and, in
the spirit of meekness, will register only necessary concerns with the teacher or leaders involved
(Matthew 18:15–17).
 All final grades and credits will be held until accounts are paid in full. Records will not be transferred to
another school if money is due St. Joseph Christian.
 Our commitment to God's mandate to train our child(ren) after the example of Christ and support the
school and church in pursuit of that goal.
 The administration will be responsible for placing our student(s) in the proper grade level or class
section.

Signature of Concurrence (Father) ____________________________________________Date______________

Signature of Concurrence (Mother) ____________________________________________Date______________

St. Joseph Christian School is fully accredited grades K–12 by the Association of Christian Schools International (ACSI) and North
Central Association Commission on Accreditation and School Improvement Association (NCA CASI).