Advanced Christian High School Post Office Box 97, Paso Robles, CA 93447-0097 Telephone (805) 239-0707 Fax (805) 238-1133 Registration Application (One per family. Please print in black ink)
Date of Application_____________________ For School Year _______________
Family Name ___________________________________________________________________________________ Last Husband's First Name Wife's First Name Home Address __________________________________________________________________________________ Street City State Zip Mailing Address (if different) ______________________________________________________________________
Telephone Number: Home __________________Work ____________________Mobile (cell) _________________
Referred to School By ____________________________________________________________________________
Name of Church _____________________________________Pastor __________________Attend Regularly?______
Student/Children Information (Please list ALL children living at home) Complete First, Middle, Last Names* Sex Birthdates Birthplace SS# Age Grade School(ACTS or)
*List Last Name only if different from Family Name. Attach paper if additional children living at home.
Registration FeesSee Financial Information Page for amounts:
New Family Registration $_______ + Student Registration $______ + Tuition $ = $_________
Total Amount enclosed/attached to application $ _________
Please complete the remaining three pages of this application, sign bottom of pages two and four. Enclose refundable registration fee and mail to: ACTS P.O. Box 97 Paso Robles, CA. 93447-0097
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Home School Legal Defense Association (HSLDA) HSLDA provides nationwide legal protection to all home educating families and membership is strongly encouraged. ACTS does not provide legal advice or offer legal protection in the event of threats of legal action by local authorities.
Are you currently a member? ______If so, what is your renewal date? _______________Membership # _______ HSLDA discount is available for ACTS families. Are you planning on becoming a HSLDA member? _________
Parent Information
Father's Place of Employment __________________________________________Occupation ________________
Marital Statues ___ Married ___Divorced ___ Remarried ___Widowed ___Single If biological parents do not live at the same address, please list information of parent not living with child(ren):
Name _________________________________________________________________________________________
Is this parent in agreement about home education for the child(ren)? _______________________________________ Explain on separate paper if necessary)
Medical Information
In the rare instance of a medical emergency at a school-sponsored activity in which the parents cannot be reached, we will need the following information, including the signed release below, which covers all children enrolled at Advanced Christian Training Schools. First Aid: May we administer regular first aid including ambulance if deemed appropriate? ____ Yes ___No Do you authorize hospital or doctor to administer necessary medical treatment? ____ Yes ___No Does any child have a serious health problem? ___ Yes ___ No Identify if yes _______________
Child's Name ____________________________________ Problem ______________________________
Child's Name ____________________________________ Problem ______________________________
Emergency Contacts (at least two besides the parents)
Name __________________________________________ Phone # _______________________________
Name __________________________________________ Phone # _______________________________
The school does not pay physician fees or medical expenses of students who are injured at school or at school-sponsored activities. Student Medical Insurance is optional and not required. So the children have medical insurance: ___ Yes ___ No If yes, please fill in the following:
Name of Insurance Co. ____________________Policy # _________________ Phone # ______________
Authorized Signature (Parent of Legal Guardian)______________________________________________
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Faculty Information
Student will be taught by (name of primary teacher)
Name/Address/Phone number of secondary teacher (if any, other than parent)
To your knowledge, do any of the above teachers have a felony conviction for any offense? ___ Yes ___ No If yes, please explain:
Primary location of instruction will be
As a private school we are required by law to keep on file the qualifications of our teachers. Returning faculty: List only additional training that you have received this year. New faculty: Please list your qualifications. ( Include schools attended, degrees/or credentials, teaching experience, other education or related experience such as Sunday School teacher, etc .) Attach additional page if necessary.
Father:
Mother:
Comments: Briefly state your reasons for choosing home education. Please list any special information about family or students that would help us understand your situation such as learning disabilities, IEP, skipped or repeated grades, special interests or abilities or family situations. Information provided here will be confidential.
Transfer of Records
If your child has previously attended another school, we will send for his/her cumulative record file. Please fill in the following information completely for last school attended. Legal Names of Student Birthdates Last School Attended (Name/Address)
4 ACTS SCHOOL POLICIES "Train up a child in the way he should go and when he is old he will not depart from it." Proverbs 22:6
Please read the following statements. If you are in agreement and will abide by these policies, sign at the bottom and return with your registration fee.
l. Due to the ambiguous political legal position of private home education programs, we understand that the school. cannot offer legal immunity and is only providing school services to assist parents in the education of their children. ACTS exists to assist and encourage Christian families in training Godly young men and women to grow in the nurture and admonition of the Lord. (Col. 3:21; Deut. 6:7)
2. We agree to pray about becoming members of HOME SCHOOL LEGAL DEFENSE ASSOCIATON. A. discount is available when you join through ACTS. The ACTS school discount number is #293275. HSLDA fees are paid directly to HSLDA, P.O. Box 3000, Purcellville, VA 20134. The current fee is listed in ACTS Financial Information.
3. We agree that at least one parent will attend the monthly ACTS Evening teachers meetings. We understand that more than two absences will be cause for review of our enrollment status and/or termination of enrollment.
4. We realize that although ACTS is keeping our children's records, it is not responsible for their actual education. We believe that Godly Christian parents are responsible to God for the education of their children. (Deut. 6:7; Mal. 3:6)
5. We have read the school's Statement of Faith below, ad we are in agreement with it. We acknowledge that the Bible is the inspired, inerrant Word of God. (2 Tim. 3:16) and that we can be saved only by faith in our Lord and Savior Jesus Christ. (Eph. 2:8, 9)
6. We agree to read the ACTS School Handbook and make every attempt to uphold school requirements particularly in the sensitive areas of school dress standards and music standards for ACTS events. We also understand that when our children attend school sponsored activities the parents are required to attend with them and are responsible for their safety and supervision.
7. We understand that failure to pay tuition for more than two consecutive months without notifying the school of extenuating circumstances will result in automatic dismissal.
8. We further understand that our responsibilities as parents are as follows: a. Both parents must be in agreement concerning the commitment to home education b. Parents agree to diligently and consistently teach their student(s) reasonable course of study and provide parental supervision during school hours. (Monday through Friday from 8 a.m. to 3 p.m.) c. The school will supply record-keeping forms. Parents will keep records and provide reports to the school on a monthly basis. If reports and fees are delinquent, late fees will be imposed. d. Parents will provide and pay for their own curriculum and student insurance coverage, if desired.
Statement of Faith We believe the Bible to be the inspired Word of God, the final authority of faith and life, without error in its original writing both in doctrine and historical details, and that all true knowledge in consistent with its revelation. We believe that there is one God, manifest in three persons, Father, Son and Holy Spirit, and that knowing Him truly is the foundation of all wisdom and knowledge. We believe that Jesus Christ is the Son of God manifest in the flesh, born of a virgin, that He is the Savior of mankind through His death on the cross, and that he rose from the dead, ascended to heaven and will return.
Consent to Policy We have read the above policies and agree to abide by them. It is understood that the services of the school are engaged by mutual consent and that either the undersigned or the school reserve the right to terminate all services at any time by written notification.
Father's signature ___________________________________________________________ Date __________________
Mother's signature __________________________________________________________ Date __________________ (All applications are subject to school board approval.)
PLEASE ENCLOSE CURRENT FAMILY PHOTO WITH COMPLETED APPLICATION OR EMAIL DIGITAL PHOTO TO acts@actsedu.org