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Kindergarten 3, 4, and 5 Application

To print a paper application to fill out, click here.  

A Parent or Guardian must answer all of the questions before the application will be considered.

* Indicate a required field. If there is no information available for that field, type "none" or "not available".

STUDENT INFORMATION

Please give the legal name of the student:
*Last: *First: *Middle: Gender:M F

*Preferred Name: *Birth date: *Age: *Home Phone:

Address:
     *Street: *City: *State: *Zip:

U.S. Citizen? Yes No     Grade to Enter?

Do you presently have other children enrolled in WCA? Yes No

*How did you hear about WCA?

Do you plan to continue your child's elementary education at WCA? Yes No

FAMILY INFORMATION

Father's Information:

     *Name: Living with the family? Yes No

     WCA Alumnus? Yes No     Grace Baptist Church member? Yes No

     Address:
          *Street: *City: *State: *Zip:

     *Home Phone: *Work Phone: *Cell Phone:

Mother's Information:

     *Name: Living with the family? Yes No

     WCA Alumnus? Yes No     Grace Baptist Church member? Yes No

     Address:
          *Street: *City: *State: *Zip:

     *Home Phone: *Work Phone: *Cell Phone:

Parent's Marital Status: Married Separated Divorced Widowed Single

Guardian's Information:

     Name(s): Relationship:

     WCA Alumnus(i)? Yes No     Grace Baptist Church member(s)? Yes No

     Address: 
          Street: City: State: Zip:

     Home Phone: Work Phone: Cell Phone:

*Who has legal custody of this child?

STUDENT PROFILE

Last Program Attended:

     Name:
     Address:
          Street: City: State: Zip:

     Previous Program's Director: Phone #:

     Reason for leaving Previous Program:
         

Has this student experienced academic, social, or disciplinary problems during his/her school career?
Yes No
     If yes, identify the areas and explain:
         

Has this child ever been diagnosed as having a learning disability? Yes No
     If yes, identify and explain:
         

Has he/she been diagnosed as having any condition that would affect educational performance? Yes No
     If yes, please explain:
         

Has the student ever been recommended for special testing services? Yes No
     If yes, please identify and explain:
         

GENERAL INFORMATION

*Why do you want your child to attend Wilmington Christian Academy?
    

*Briefly state your philosophy on child discipline:
    

Does this child attend Sunday school and church regularly? Yes No     Parents/Guardians? Yes No

Are you active members? Yes No     *The family's church:

*Pastor's Name: *Phone:

Are you a Christian? If yes, on what do you base your answer?

     Father: Yes No
     Basis:
          		     Mother: Yes No
     Basis:
         

REFERENCES

Friend or Associate (not a relative) who knows you well.

     *Name: *Phone:
     Address:
          *Street: *City: *State: *Zip:
         

Please take a moment to scroll up and take a final look at your application. Read the below statement and click the circle indicating your agreement with the statement. Type your name and e-mail address as the preparer of the application and click the submit button. When you click the submit button, a check will be made of the required fields, and if you missed a field, you will be asked to fill it in before the application is submitted. If no information is available for a required field, type "none" or "not available" and then resubmit.

To the best of my knowledge, the information given on this application is true and accurate: Yes No 

*Your Name: *Your E-mail:

Updated: 1/09