Application for admission - Cornerstone Christian Academy



Full name of oldest student

___________________________________________________________________ Date of Birth _________________ Sex: (M (F First Middle Last

Home Phone: __________________Cell:_____________________E-Mail____________________________________

Address: ________________________________________________________________________________________

Street City Zip

Applicant’s church membership or preference: __________________________________________________________

Please provide the email address you would like to have as receiving emails from the Email Group: _____________________________________________

Describe any physical or mental limitations the applicant(s) may have: _________________________________________

__________________________________________________________________________________________________

Program for which you are applying:

(Full Day (Core Curriculum (Home-School: #days/week ________

(Kindergarten: (1st Grade (2nd Grade (3rd Grade (4th Grade (5th Grade (6th Grade (7th Grade

(8th Grade ( 9th Grade ( 10th Grade ( 11th Grade (12th Grade

Full name of 2nd Student:

_______________________________________________________ Date of Birth _________________ Sex: (M (F

First Middle Last

Program for which you are applying:

(Full Day ( Core Curriculum ( Home-School: #days/week______

(Kindergarten: (1st Grade (2nd Grade (3rd Grade (4th Grade (5th Grade (6th Grade (7th Grade

(8th Grade (9th Grade( 10th Grade ( 11th Grade (12th Grade

Full name of 3rd Student:

_______________________________________________________ Date of Birth_______________ Sex: (M (F First Middle Last

Program for which you are applying:

(Full Day (Core Curriculum (Home-School: #days/week__________

(Kindergarten: (1st Grade (2nd Grade (3rd Grade (4th Grade (5th Grade (6th Grade (7th Grade

(8th Grade (9th Grade( 10th Grade ( 11th Grade (12th Grade

Full name of 4th Student:

__________________________________________________ Date of Birth __________________ Sex: (M (F

First Middle Last

Program for which you are applying:

(Full Day (Core Curriculum (Home-School: #days/week __________

(Kindergarten: (1st Grade (2nd Grade (3rd Grade (4th Grade (5th Grade (6th Grade (7th Grade (8th Grade ( 9th Grade( 10th Grade ( 11th Grade (12th Grade

1st Student:

Former school attended: _________________________________Location: ____________________________

References:

Religious: Minister, Elder, or teacher: __________________________________________________________

Name Telephone

School: Principal or teachers: ___________________________________________________________________

Name Telephone

2nd Student:

Former school attended: _________________________________Location: ____________________________

References:

Religious: Minister, Elder, or teacher: __________________________________________________________

Name Telephone

School: Principal or teachers: ___________________________________________________________________

Name Telephone

3rd Student:

Former school attended: _________________________________Location: ____________________________

References:

Religious: Minister, Elder, or teacher: __________________________________________________________

Name Telephone

School: Principal or teachers: ___________________________________________________________________

Name Telephone

4th Student:

Former school attended: _________________________________Location: ____________________________

References:

Religious: Minister, Elder, or teacher: __________________________________________________________

Name Telephone

School: Principal or teachers: ___________________________________________________________________

Name Telephone

I will complete an Emergency Contact/Medical Information Card after enrolling and I agree that if the school is unable to reach the emergency contacts listed, the school is authorized to secure emergency medical care for the applicant. Initial Here: ________

I am interested in my child studying the Bible daily. If accepted, we will abide by all current and future policies and regulations of the school. We have read and understood all costs relating to tuition and fees as listed in the tuition schedule and agree to meet them. Initial Here: _________

I found out about Cornerstone from or was recommended by______________________________

___________________________________________________________________________________

Parent’s signature: ___________________________________________________ Date: _________________

Registration for ___ students is $_______Paid? Y N ( Check # ______ ( Cash, receipt # ______

Annual Tuition is $_______Paid? Y N

Monthly Tuition is $_________ First Month Paid? Y N ( Check # _________ ( Cash, receipt #_________ Date: __________ Amount $_________

Comments: _________________________________________________________________

Statement of Nondiscrimination

Brazos Valley Cornerstone Christian Academy does not discriminate against any person on the basis of race, national or ethnic origin, or gender.

Board of Directors:

Jerry Hogan, Ray Hansen, Joe Hays,

Marcia Crouch, Johnece Marchbanks,

Clay Bassham, Linda Ligon, Meridon Warden.

Dr. Dean Duncan, Secretary

Dear Parents:

As we enter the new school year, we have some business to complete. As most of you know, your first payment is due in August. Your payment will be by automatic draft through our bank account connecting electronically with your checking account. We will send the request for all money transfers on the 1st of the month, starting August 1. The money will be transferred on or about the 7th of each month.

This year we are including Extended Care for those who take the Extended Care monthly. You may change this at any time provided you notify us on the 15th of the month prior to making the change.

AUTHORIZATION AGREEMENT FOR DIRECT DEPOSITS (ACH CREDITS)

(I (we) hereby authorize Cornerstone Christian Academy, to initiate credit entries from my (our)

(Checking /( Savings Account (please select one) indicated below at our bank, named below, and to credit the same to Cornerstone’s account for the amounts of our child’s tuition plus extended care listed below for the time period listed near the 7th of every month.

I (we) acknowledge that the origination of ACH transactions for my (our) account must comply with the provisions of U.S. law.

Name of Bank: _________________________ Branch # _________ City: _________

State: ______________ Zip Code: _____________________

Routing Number: _______________________ Account Number: _________________

I understand that my total tuition is $_____________ and I choose to pay this amount in the span of (10 months (12 months. My total monthly payment will be ____________ and my last month of payment will be __________. If there are changes to the amount above, then an additional sheet will be filled out and approved by the Administrator.

This authorization is to remain in full force and in effect until Cornerstone Christian Academy has received written notification from me (or either of us) of its termination in such time and in such manner as to afford Cornerstone Christian and our bank a responsible opportunity to act on it.

Name(s): ___________________________ Student(s) Name(s): __________________

Date: __________ Signature: ______________________________________________

-----------------------

Cornerstone Christian Academy

3200 Cavitt Avenue ( Bryan ( TX ( 77801 ( 979-694-8200

cornerstone-christian- ( Email: office@lindaligon@

Accredited by Southern Association of Colleges and Schools

APPLICATION FOR ADMISSION

|Father’s name: _______________________________ |Mother’s name: ______________________ |

|Preferred salutation: __________________________ |Preferred salutation: __________________ |

|His occupation: ______________________________ |Her occupation: ______________________ |

|His employer: _______________________________ |Her employer: _______________________ |

|Father’s church affiliation: _____________________ |Mother’s church affiliation: ____________ |

|Which congregation? _________________________ |Which congregation? _________________ |

|Cell ____________e-mail______________________ | Cell ___________e-mail______________ |

| | |

|Are the parents divorced? (Y) (N) | |

Children (under 18) not in our school: Grade:

__________________________________________ ________________________

__________________________________________ ________________________

For Office Use Only

Initials: ____________ Date:___________

Tuition and Fees for 2019-2020

(Significant discounts for second child and early enrollment)

|PLAN |STUDENTS |REGISTRATION |MONTHLY |YEARLY |

| | |FEE |TUITION |TUITION |

|Plan I | | | | |

|(Full Day) | | |$605.83/12mo. |$7,270.00 |

| |Kindergarten |$300 |$727.00/10mo. | |

| | | | |$7,950.00 |

| | | |$ 662.50/12mo. | |

| | | |$ 795.00/10mo. | |

| | | | |$ 8,190.00 |

| |Grades 1-5 | |$682.50/12 mo. | |

| | | |$819.00 10 mo. | |

| | | | | |

| | | | | |

| |Grades 6 - 12 | | | |

|Plan II |Morning Only | | | |

|(Morning) |(Kindergarten) | | | |

| | |$250 |$487.42/12 mo. |$5,849.00 |

| | | |$584.90/10 mo. | |

|Plan II | | | | |

|(Morning) |Morning Only | | | |

|Core Curriculum* |(Grades 1-5) | | | |

| | |$250 |$584.92/12 mo. |$7,019.00 |

| | | |$701.90/10 mo. | |

| |Home School | | | |

|Plan III | | | | |

|(Afternoon) |5 Days** | | | |

| | |$150 |$292.50/12 mo. |$3,510.00 |

| | | |$351.00/10 mo. | |

~ To keep your costs low, tuition is paid year-round ~

* This price is for a 51/2-hour day.

** This price is for a 5-day week.

Individual programs vary in cost.

Extended Care Information and Registration

Please indicate # children and times below:

Parent’s Signature: _______________________________________Date to begin: _____________________

Drop in rate: $7.50 hr ( children picked up any time after 3:30pm will result in a charge of no less than $3.25 for half hour) Invoices will be sent out monthly, you will be billed the drop in rate or charged according to the charts below whichever is the lesser.

Afterschool Care for _______ students.

( 1 days/week = $30.00/month (up to 2 children)

*3 or more children will be additional $15 per month

( 2 days/week = $60.00/month (up to 2 children)

*3 or more children will be additional $30 per month

( 3 days/week = $90.00/month (up to 2 children)

*3 or more children will be additional $45 per month

( 4 days/week = $120.00/month (up to 2 children)

*3 or more children will be additional $60 per month

Daily after school care for _______ students.

*5 days/week

( 3:30-4:30 = $80.00 per month (up to 2 children)

*3 or more children will be additional $40 per month

( 3:30-5:00 = $120.00 per month (up to 2 children)

*3 or more children will be additional $60 per month

( 3:30-5:30 =$160.00 per month (up to 2 children)

*3 or more children will be additional $80 per month

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