Student Name (last, first, middle)

Student's gender

Grade applying for:

Student Address (including city and zip):

Student's date of birth:

Student's place of birth (city, state, country):

School last attended:

School Address & Phone (street, city, state, zip, phone):

Student's special medical needs (if any):

Student's interests (please select any that apply):

If you selected athletic interest above, please specify which sport(s):

Student lives at:

Has this child ever been suspended or put on probation from any school?

If yes, please explain:

Has this child had any failing grades in his/her report card during the past two years?

If yes, please explain:

Father's name:

Father's address:

Father's email:

Father's home phone:

Father's business phone:

Father's cell phone:

Father's place of birth (city, state, country):

Father's marital status:

Father's employer:

Father's position:

Father's employer's address:

Father is interested in volunteering?

Mother's name:

Mother's address:

Mother's email:

Mother's home phone:

Mother's business phone:

Mother's cell phone:

Mother's place of birth (city, state, country)

Mother's marital status:

Mother's employer

Mother's position:

Mother's employer's address:

Mother is interested in volunteering?

Number of children in entire family:

Names & ages of children in the family:

What church does your family attend?

Student's Spiritual Life (to be completed by students entering grades 7-12):

What is your relationship with Jesus Christ?

Student's Spiritual Life (to be completed by students entering grades 7-12):

Why do you want to attend Ontario Christian School?

Date that student answered these questions:

Please give the name of the main or senior pastor of your church: