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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