Conecuh Springs Christian School

220 Hicks Industrial Blvd*Union Springs, AL 36089

334-738-4800*Fax 334-738-4807

Application For Admission

Application for Grade______Date______Social Security #______

Applicant Name______

LastMiddleFirstName Used

Date of Birth______Place of Birth______Gender______

Applicant's Current School______Phone (____)______

Address of School ______

StreetCityStateZip

Principal or Headmaster ______

Child resides with Mother Father Both Parents Guardian/other ______

Has the child or a sibling ever been enrolled in CSCS daycare or CSCS School? _____ What year?____

Sibling(s) name(s)______

Father/Guardian's Name______

Home Address______

StreetCityStateZip

Home Phone (____)______Business Phone (____)______

Cell Phone (____)______Email______

Business/Firm______Position______

Mother/Guardian's Name______

Home Address______

StreetCityStateZip

Home Phone (____)______Business Phone (____)______

Cell Phone (____)______Email______

Business/Firm______Position______

Has the applicant ever violated school policies resulting in suspension or expulsion from school? If yes, please explain.______

______

______

Is the applicant eligible to return to his/her current school? If no, please explain.______

______

______

Are there any conditions or circumstances the admissions team should consider in evaluating the applicant's transcripts and standardized test scores? If yes, please explain.______

______

______

______

Admission Procedures: The following procedures must be completed to be considered for admission to Conecuh Springs Christian School.

  • Complete the admissions application.
  • Background Check: The following must be received before an applicant can be enrolled at CSCS:
  • Transcript/current report card
  • Copies of standardized testing (last three years if available)
  • Copies of disciplinary records (if applicable)
  • Copies of attendance records (may be included with transcript)
  • Copies of birth certificate and social security card
  • References: Two previous teacher and one administrator or counselor evaluations must be requested. Kindergarten only requires one from teacher or administrator. This section does not apply to pre-school applicants.
  • Drug Test: Administered at Conecuh Springs Christian School (for grades 9-12), and a fee of $55 is required for the testing. This fee will be deducted from the student comprehensive fees upon acceptance to CSCS at the time of registration. Please sign below indicating authorization for drug testing:

______

Parent/Guardian Signature Date Student Signature Date

  • Parent and student meeting with Admissions Committee
  • Prior to processing any contract, the School Board will review enrollment to ensure vacancy is available. They will also be responsible for maintaining the waiting list should classes reach maximum capacity notifying parent(s) of the waiting status.
  • Application forwarded to school office for further processing.

Admission Policy

Students are considered for admissions on the basis of, but not limited to, academic achievement, academic testing, attendance record, teacher evaluations, administrator evaluations and citizenship. Other factors that are considered include extra-curricular interests, talents, classroom scheduling capabilities, and space availability. If a student is accepted for the following school year, his/her final report card will also be evaluated. All new students are accepted on a trial basis for a period of one semester. Please note that we are not able to make significant modifications or accommodations for special needs. All students in grades 9-12 are drug tested within the first month of school. I give permission to Conecuh Springs Christian School to use my child's picture in school publications/advertisements.

Date of application______

Parent/Guardian Signature

Conecuh Springs Christian School admits students of any race, color, and national or ethnic origin to all rights, privileges, programs, and activities generally accorded or made available to students at our school and does not discriminate on this basis of race, color, and national or ethnic origin in administration of our educational policies, admissions policies, scholarship and loan programs, and athletic and other school-administered programs.

Conecuh Springs Christian School is accredited by the National Private Schools Association Alliance.

Conecuh Springs Christian School Board of Directors reserves the right to alter, amend, or change the policies as necessary.

Questions

Questions regarding Conecuh Springs Christian School and the admissions procedure should be directed to:

Mona E. Padgett, Administrator

334-738-4800

Fax 334-738-4807

Email

Please return the completed application with required documents and application fee to:

Conecuh Springs Christian School

Attention: Admissions

220 Hicks Industrial Blvd

Union Springs, AL 36089

Conecuh Springs Christian School

Confidential Evaluation Form

Must come from a current teacher in a core subject area or an administrator

Grades 7-12

Applicant's Legal Name: ______Applicant for Grade:_____

First Middle Last

I understand that this recommendation is confidential and will not be made available for student or parent review.

Parent/Guardian Signature:______Date:______

The applicant whose name is indicated above is presenting an application for admission to Conecuh Springs Christian School. Your evaluation of his/her academic performance, intellectual promise, and personal qualities, will assist the Admission Committee in making an informed decision. Your comments are held in confidence and only shared with the Admission Committee. A quick response is greatly important as we do not consider an applicant until all evaluations are received. Please complete this form and return it to:

Conecuh Springs Christian School, Attn: Admissions, 220 Hicks Industrial Blvd, Union Springs, AL 36089

ACADEMIC ABILITIES

NO

EXCELLENT GOOD FAIR LIMITED EVALUATION

Place a check mark in the appropriate box

ACADEMIC POTENTIAL
CRITICAL THINKING SKILLS
MOTIVATION
STUDY SKILLS
ORGANIZATIONAL SKILLS
INTELLECTUAL INTEREST
CREATIVITY
DETERMINATION
READING COMPREHENSION
BASIC MATH SKILLS
ABILITY TO GRASP NEW CONCEPTS
ABILITY TO EXPRESS IDEAS IN WRITING
ABILITY TO EXPRESS IDEAS ORALLY

PLEASE LIST THE STRENGTHS AND NEEDS OF THE APPLICANT IN THE SPACE PROVIDED.

Greatest Strengths:

Greatest Needs:

CHARACTER - PERSONALITY

Place a check mark in the appropriate box

ATTITUDE ABOUT SCHOOL / EXCELLENT / GOOD / AVERAGE / POOR
PERSONALITY / DOER / INTERACTIVE / SUPPORTIVE / CAUTIOUS
CONCERN FOR OTHERS / ACTIVE / INVOLVED / LACKING / INDIFFERENT
SOCIAL RELATIONS W/PEERS / VERY HEALTHY / GOOD / PROBLEMS / POOR RELATIONS
CLASS PARTICIPATION / ACTIVE / INVOLVED / LACKING / DOMINATES
WORKS IN A GROUP / WORKS WELL / SOMETIMES / DIFFICULTY / MANY PROBLEMS
SHOWS INITIATIVE / ALWAYS / USUALLY / SOMETIMES / RARELY
ATTENTION SPAN / ENGAGED / ATTENTIVE / VARIES / NEEDS DIRECTION
FOLLOW DIRECTIONS / ALWAYS / USUALLY / SOMETIMES / RARELY
INTERACTION W/TEACHERS / EXCELLENT / POSITIVE / PROBLEMS / POOR RESPECT
WORKS INDEPENDENTLY / EXCELLENT / GOOD / NEEDS HELP / CONSTANT HELP
CLASSROOM BEHAVIOR / EXCELLENT / GOOD / AVERAGE / POOR
COMPLETES ASSIGNMENTS / CONSISTENTLY / USUALLY / NEEDS TIME / DIFFICULTY
FINE MOTOR SKILLS / EXCELLENT / GOOD / AVERAGE / POOR

PLEASE ANSWER THE FOLLOWING QUESTION ABOUT THE APPLICANT IN THE SPACE PROVIDED.

Do you have any reason to question the academic or personal integrity of the applicant? ______Yes ______No

If yes, please explain:

Other comments:

THANK YOU FOR YOUR TIME AND EVALUATION OF THIS APPLICANT. IF YOU FEEL UNCOMFORTABLE WRITING SOME OF THE INFORMATION AND WOULD LIKE TO EXPRESS IT VERBALLY, PLEASE LEAVE YOUR PHONE NUMBER BELOW.

I have known the applicant for ______years ______months.

My relationship has been that of _____ current teacher _____ former teacher ______other

What subject areas do you teach?______

What are the first few words that come to mind when describing this applicant?:______

______

Evaluator's name:______Phone:______

(Only if you wish to talk with us)

Evaluator's signature:______Date:______

School Name:______

School Address: ______

School Telephone Number:______Email Address:______

Please return to Conecuh Springs Christian School, Attn: Admissions, 220 Hicks Industrial Blvd, Union Springs, AL 36089