CHURCH
SCHOOL ENROLLMENT FORM
School
Year: _________ Public School District: _______________________
I.
TO BE COMPLETED BY PARENT OR GUARDIAN
Student’s
Name: _______________________ Home Phone: ____________
Address: ______________________________________________________
Date of Birth: _____________________________ Grade: ______________
Parent
or Guardians Name: __________________ Home phone: _________
Address: ______________________________________________________
Church
School of Enrollment: ________________ School Phone__________
Address: ______________________________________________________
______________________________________________________________
Date / Signature of Parent or Guardian
II.
TO BE COMPLETED BY CHURCH SCHOOL ADMINISTRATOR
Church School: _________________________ School Phone____________
Address: ______________________________________________________
Date of
Student Enrollment:______________ for ___________ school year
______________________________________________________________
Date/Signature of Administrator
III.
CONSENT FOR NOTIFICATION OF STUDENT WITHDRAWAL
I hereby give prior
consent to the administrator of the above name church school to notify
the public school superintendent should the above named student cease
attendance at said school
______________________________________________________________
Date/Signature of Parent or Guardian
***
Notice: Parent/Guardian must sign and date in both Sections I &
III. |