EPHESUS ACADEMY
829 McMillon Avenue SW u Birmingham, AL 35211-1730 u (205) 786-2565 Off u (205) 786-2567 Fax
STUDENT APPLICATION FOR ADMISSION
Date of Application: _____/_____/_____ Grade Entering: _____ 1st Semester: 20_____ 2nd Semester: 20_____
STUDENT INFORMATION: Please update information:
Full legal name: ______
LAST FIRST MIDDLE NICKNAME
Permanent Address: ______
STREET CITY STATE ZIP CODE
Telephone: ______-______-______SSN# ______-______-______U. S. Citizen: YES_____ NO_____
Date of Birth: _____/_____/_____ Place of Birth: ______
CITY / STATE
Emergency Contact Name: ______Relationship to child: ______
Home phone: ______-______-______Work phone: ______-______-______
PARENT/GUARDIAN INFORMATION
A) FATHER NAME ______natural step guardian (please circle one)
ADDRESS______
BUSINESS NAME ______
PHONE ______HOME ______WORK
Cell ______
B) MOTHER NAME ______natural step guardian (please circle one)
ADDRESS______
BUSINESS NAME ______
PHONE ______HOME ______WORK
Cell ______
______
STUDENT’S SIGNATURE / DATE PARENT’S SIGNATURE / DATE
OFFICE USE ONLY
OFFICIAL’S NAME: ______ACCEPTED: YES NO DATE: _____/_____/_____
EPHESUS ACADEMY
829 McMillon Avenue SW u Birmingham, AL 35211-1730 u (205) 786-2565 Off u (205) 786-2567 Fax
Student’s Creed
Higher than the highest human thought can reach is God’s ideal for His children. Godliness, God-likeness, is the goal to be reached. Before me there is a path of continual progress. I have an object to achieve, a standard to attain that includes everything good, and pure, and noble.
I will use my time wisely today!
I will learn something new today!
I will be successful today!
I will have no other gods before Thee.
I will not make unto Thee any graven images, nor bow down myself to serve them.
I will not take the name of the Lord (my God) in vain.
I will remember the Sabbath day.
I will honor my father and my mother.
I will not kill.
I will not commit adultery
I will not steal.
I will not bear false witness against my neighbors.
I will not covet anything that is my neighbor’s.
My happiness for this life and for the future immortal life lies with me. I will not be content with dull thoughts, an indolent mind, or a loose memory. I will seek higher attainments.
Christ will be the center of my life and I will be a servant of God and a friend to man. This is my time, my place, and my opportunity. I accept the challenge to be all I can be.
Because I am Somebody
I am Somebody
I may be African-American,
I may be Caucasian,
I may be Hispanic
I may be Native American,
I may be Asian,
I may be Caribbean,
I may be Young,
But I am Somebody
I am Somebody
I AM S-O-M-E-B-O-D-Y!
--- Author Unknown ---
Pledges
Bible:
I pledge allegiance to the Bible, God’s Holy Word
I will make it a lamp unto my feet, and a light unto my path.
It’s words will I hide in my heart that I might not sin against God.
Christian Flag:
I pledge allegiance to the Christian flag, and the Savior for whose kingdom it stands. One Savior crucified,
risen, and coming again, with life and liberty, for all who believe.
American Flag:
I pledge allegiance to the flag of the United States of America, and to the Republic for which it stands, one nation under God, indivisible, with liberty and justice for all.