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General Information 2022
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2022 Medication Authorization 2022

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Current Student

Family and Student Questionnaire 2022

If you don’t want to submit the form online you can click the link below to download the file and submit to our school.

Family and Student Questionnaire

Family and Student Questionnaire

Parent/Guardian *

Telephone *

Email *

Child's name *

Grade *

1. Please describe your relationship to the Lord Jesus Christ (parent 1). *

1. Please describe your relationship to the Lord Jesus Christ (parent2 ).

2. Are both parents in agreement on enrollment? *

Yes

No

3. Are you a member of any church? *

Yes

No

4. Please explain your reasons for choosing CRCS as the educational choice for your student. *

5. What is your perspective concerning the school’s responsibility in disciplining and guiding your child? *

6. Will your child have any difficulty communicating in English? *

Yes

No

7. Has your child ever been referred for a developmental or academic evaluation? *

Yes

No

If YES to question #7, please provide details below

8. Has your child been sent to a principal, director, or guidance counselor for previous disciplinary problems? *

Yes

No

9. Why did you withdraw your child from your last school? *

Please fill out the “Permission to Release Information” form in the Registration Packet.

QUESTIONS 10 - 14 (KINDERGARTEN - 6TH GRADE ONLY)

10. Has your child ever been suspended, dismissed, or denied reenrollment from an educational or extended care program for academic, disciplinary, or other reasons? *

Yes

No

11. Has your child experienced any of the following academic accommodations?

Tutoring *

Yes

No

Modification of grading scale *

Yes

No

Modification of work load *

Yes

No

Special classroom accommodations (oral testing, extended time) *

Yes

No

12. Does your child have a history of:

ADD, ADHD (copy of diagnosis by a licensed psychologist or physician must accompany application) *

Yes

No

Learning Disability (copy of testing and Individual Education Plan must accompany application) *

Yes

No

Physical Disability (copy of Individual Education Plan must accompany application) *

Yes

No

Other, please indicate *

13. Has your child ever repeated a grade level? *

Yes

No

If yes, which grade and for what reasons. *

14. Has your child received a physical, visual, and hearing examination in the last year? *

Yes

No

If so, please give results. *

Students with academic difficulties applying for admission to Calvary Road Christian School must supply all confidential records, present school records, and any educational evaluations before the admissions process can proceed.

I acknowledge that I have accurately completed the Family and Student Questionnaire and have supplied all records, evaluations, IEP’s and other information if applicable. I understand that by omitting any information, or falsifying of documents, I am jeopardizing my child’s acceptance or continued enrollment.

*

I agree to the terms and conditions mentioned above.

Note: please click SUBMIT before proceeding to the next section

If you are human, leave this field blank.

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