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Middle School Application
Grades 6 - 8

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.

* Indicates 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?

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?

ACADEMIC BACKGROUND

*List schools previously attended by applicant:

School Name, Address, Phone Date(s) Grade Levels

*Reason for leaving Previous School:
    

Student's Grades Have Been: Superior Above Average Average Below Average

Has the student failed any grade? Yes No     If yes, which grade:

Was this student absent more than 10 days during the most recent school term? Yes No
     If yes, please explain:
         

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

Has he/she been expelled or given an in-school or out-of-school suspension during his/her school career?
Yes No
     If yes, explain:
         

Has this child ever been recommended for testing or diagnosed as having a learning disability or any condition that would affect educational performance? Yes No
     If yes, identify and explain:
         

Has your child experienced a traumatic event that could affect his/her behavior or academic performance?
Yes No
     If yes, please explain:
         

Is this student currently taking any prescription medications to aid behavior or educational performance?
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:
    

Do you (parents/guardians) attend church regularly? Yes No     Child? 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