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Please check one box
*
New Student
Re-Enrolling Student
Student Information
(
Please give legal name of student
)
*
Indicates required field
Gender
*
Male
Female
Name
*
First
Last
Preferred Name
*
Birthdate
*
Age
*
Phone Number
*
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Grade to Enter
*
Will you be enrolling any other children into HBCA?
*
Yes
No
If yes, how many?
If Yes, how many?
*
Family Information
FATHER'S NAME
*
First
Last
Occupation
*
Employer
*
Work Phone
*
Email
*
Cell Phone
*
MOTHER'S NAME
*
First
Last
Occupation
*
Employer
*
Work Phone
*
Cell Phone
*
GUARDIAN(S)
*
First
Last
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Work Phone
*
Cell Phone
*
PARENTS' MARITAL STATUS
*
Select one
Married
Separated
Divorced
Widowed
Single
Who has legal custody of the child?
*
Are you a member of Bible Baptist Church?
*
Yes
No
Academic Background
(list schools previously attended by applicant)
School Name, Address, and Phone
*
School Name, Address, and Phone
*
School Name, Address, and Phone
*
Date(s)
*
Date(s)
*
Date(s)
*
Grade levels
*
Grade levels
*
Grade levels
*
Reason(s) for leaving previous school(s)?
*
Has student been expelled from school?
*
Yes
No
If yes, give reason:
*
Note: Filling out application does not guarantee admission to HBCA. Your application will be reviewed and you will be contacted of your child's admission status. There is a $25 application fee that will be charged if there is a personal interview.
Submit