School Enrollment Please enable JavaScript in your browser to complete this form. - Step 1 of 4Student InformationName *FirstMiddleLastGrade Entering *Gender *MaleFemaleDate of Birth *MM123456789101112/DD12345678910111213141516171819202122232425262728293031/YYYY202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Address *Address Line 1Address Line 2CityCaliforniaAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeEmail *Has your student ever repeated a grade? *YesNoIf yes, which grade and why?Has your student ever been dismissed or expelled? *YesNoIf yes, please explainDoes your student have any medical conditions? *YesNoIf yes, please describe.Is your student taking any medications? *YesNoIf yes, please describe reason(s). Has your student been tested or diagnosed with learning challenges? *YesNoIf yes, please describe.Does your student currently have: *504 PlanIEP Not ApplicableHow did you hear about Tabernacle? *ReferralReferralFlyerWebsite/OnlineOtherReferral NamePlease explain other. Schools that are recipients of federal dollars are required by the Federal government to solicit certain demographic information to meet federal reporting requirements. Applications are requested to provide the following information voluntarily. This information will not be utilized in a discriminatory manner.I do not wish to furnish this informationRace / OriginHispanic or LatinoAsianBlack or African AmericanAmerican Indian or Alaskan NativeNative Hawaiian or other Pacific IslanderWhiteBi-racialPrimary Home LanguageParent/Guardian that lives at the above student addressStudent resides with *Both ParentsMother OnlyFather OnlyLegal GuardianJoint CustodyGrandparentOther (Specify)Name *FirstMiddleLastRelationship to Student *Parent/Guaridan Marital Status *MarriedDivorcedSeparatedSingleWidow/widowerPhone Number *Home PhoneCell PhoneEmail (Primary communication method) *Work Place *Work Phone *Family ChurchDenominationSecond AdultNameFirstMiddleLastRelationship to StudentParent/Guaridan Marital Status MarriedDivorcedSeparatedSingleWidow/widowerPhone NumberHome PhoneCell PhoneEmail (Primary communication method)Address (If different from student)Address Line 1Address Line 2CityState / Province / RegionPostal CodeAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Province of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountryWork Place Work Phone Family Church (If different from above)Denomination (If different from above)Program Applying for *Junior Kindergarten 8:30-12:00Junior Kindergarten 8:30-3:30Junior Kindergarten 6:30-6:30Transitional Kindergarten 8:30-2:30Kindergarten 8:30-2:301st-5th (Elementary)6th-8th (Middle School)Full Time Daycare 6:30-6:30Drop in DaycareNextEmergency Contact InformationFirst Contact: Parent/Guardian Name *FirstLastBest Phone Number *Alternate Phone Number Second Contact: Parent/Guardian Name FirstLastBest Phone Number Alternate Phone Number In case of an emergency and the above cannot be reached.First Contact: Name *FirstLastRelationship to student *Best Phone Number *Add another emergency contactSecond Contact: Name FirstLastRelationship to student Best Phone Number Authorized to Pick Up Child (in addition to above)Name *FirstLastRelationship to student *Best Phone Number *Add another authorized pick upName FirstLastRelationship to student Best Phone Number Add another authorized pick upName FirstLastRelationship to student Best Phone Number Tabernacle Financial AgreementI understand that when I register my child(ren) at Tabernacle School, I accept full responsibility to pay all tuition, registration charges, fees, and other associated costs assessed as a result of my registration and/or receipt of services. I understand and agree that if I withdraw my child(ren) from some or all of the classes, I will be responsible for paying all or a portion of the tuition and fees. I understand that payments in full must be made on the tenth of each month to be considered current. I fully understand the financial policies of the school. I understand that children are not accepted on a month-to-month basis, and upon enrolling my child, i affirm that I am morally and financially obligated to maintain enrollment for the complete school year. It is my understanding that the policy for the school is to make no refund of registration fees or tuition. "Providing for honest things, not only in the sight of the Lord but also in the sight of men" (II Corinthians 8:21).I pledge to pay my financial obligations to Tabernacle School on the due date. All payments towards fees must be in by the tenth of each month. I do understand that a late fee is due after the tenth of the month and that if tuition is not received by the last day of the month, my child will not be able to attend school until payment is brought up to date. I also understand that the school is unable to adjust tuition due to vacations, and that in order to keep my child in the school my monthly payments towards the charges must be kept up to date.Disenrollment from Classes Due to Non-PaymentI understand that my child(ren) may be dis-enrolled from Tabernacle if I fail to pay all fees by the deadline. I understand that administrative, clerical, or technical billing errors do not absolve me of my financial responsibility to pay the correct amount of tuition; fees and other associated financial obligations assessed. Date *Name of Financially Responsible Party *FirstLastSignature of Financially Responsible Party *Clear SignaturePreviousNextStatement of Cooperation for Parents or GuardiansIn submitting this application for my child to attend Tabernacle School, I fully understand that the school needs my cooperation in keeping their policies and procedures. Realizing that my attitude towards the administration, staff, and policies of Tabernacle School affects the emotional and academic stability of my child. I will support and uphold the ideals of the school in every way and abide by the decisions made by the administration.I understand the need for students to be respectful towards staff and other students, and that profanity, obscenity in word or action, and dishonor to the Word of God will not be tolerated. I fully support the zero tolerance policy the school has with regard to the following issues: The possession of or offering for sale of illegal drugs, positioning oneself as possessing and using drugs; possession of alcohol, firearms, weapons, or anything intended to be used as such; the expression of violent, threatening behavior; the possession of obscene material; immoral and/or obscene behavior or language and any activity of illegal nature. I fully support the teaching of character and self-discipline. I support the fact that acceptable behavior in the classroom and playground needs to be taught as one would teach any other subject. I understand that Tabernacle School will work with me in "training my child in the way that he should go" (Proverbs 22:6) and "bringing him up in the nurture and admonition of the Lord" (Ephesians 6). For further information, please refer to our school's Statement of Faith.I fully embrace the scriptural procedure of going directly to the teacher or administrator when problems arise. I agree that following the Matthew 18:15 principle will prevent unnecessary criticism of the staff and school. "If your fellow believer sins against you, go and tell him in private what he did wrong. If he listens to you, you have helped that person to be your brother or sister again." Should I have a grievance with Tabernacle School, i agree to first enter into arbitration before pursuing litigation.I understand that if I, or my doctor, cannot be reached in an emergency situation, Tabernacle School has my permission to seek prompt, emergency care for my child.The Statement of Cooperation for Parents or Guardians will remain in continued affect for the entire time the student is enrolled with Tabernacle School. Date *Parent/Guardian Name *FirstLastParent/Guardian Signature for Statement of Cooperation for Parents or Guardians *Clear SignatureSecond Parent/Guardian NameFirstLastSecond Parent/Guardian Signature for Statement of Cooperation for Parents or GuardiansClear SignaturePreviousNextPermission to PublishI authorize and give full consent to Tabernacle School to publish projects completed by my student while enrolled at Tabernacle School on the Tabernacle’s website. This material will only be used for activities related to Tabernacle School. No phone numbers, home addresses, screen names, email addresses, or other identifying information will be published in any form.Permission to Publish, I hereby authorize and give full consent to Tabernacle to publish and copyright all photographs in which my child or the likeness of my child appears while enrolled as a student in any and all programs of Tabernacle School. I grant permission to Tabernacle to crop photographs of my child at their discretion. I further agree that Tabernacle may transfer or use these photographs in school brochures, newsletters, advertising, posters, displays, slideshows, videotapes, catalogs, CD-ROMs, and like publications, literature, or materials without limitation or reservations.I am the parent or legal guardian of the above-named minor and hereby approve the foregoing and consent to the use of photograph, name, and published project to the pursuant terms mentioned above. I affirm that I have the legal right to issue such consent.Date *Student Name *FirstLastParent/Guardian Name *FirstLastParent/Guaridan Signature for Permission to Publish *Clear SignatureI DO NOT WANT MY CHILD'S PHOTO TO BE USED FOR ADVERTISING. (School brochures, newsletters, website, or other publications that are used to advertise the school to the public.) This does not include yearbook or Tabernacle Family only publicationsPreviousWebsiteEnroll Now Share this:TwitterFacebookLike this:Like Loading...