Family Name:
Date of Expected Enrollment:
2014-2015
CHILD DEVELOPMENT CENTER APPLICATION PROCEDURES
This application does not guarantee placement.
Preference will be given to current students, siblings, and MFFBC members.
The application process consists of the following:
ALL STUDENTS
- Submission of Enrollment Contract
- Payment of Annual Fees
- Completion of all necessary paperwork
- Submission of current immunization record
- Completed Form 2935 Signed by Physician
Texas State Law mandates that the school has on file a copy of each student’s current immunization record.
NEW STUDENTS
- Submission of student’s certified birth certificate (New Students)
- FBCS requires a certified copy of the student’s birth certificate as a protective measure for the student.
- Completion of Teacher Recommendation Form by Applicant’s Current Teacher (New Students)
- Parent Interview (New Students)
- Recent Photograph of Applicant(New Students)
- Parent of infants must attend a brief orientation of the operation of the baby area
FOR OFFICE USE ONLY
Date Submitted:Staff Initials:
Registration Fee Paid: Yes / NoMethod of Payment: Cash / Check #
Current Student: Yes / No Sibling of Current Student: Yes / No
FBC Member: Yes / No
Special Needs: Yes / NoSpecify Need:
Notes:
Annual Student Registration Forms
2014-2015
The non-refundable annual EnrollmentFee mustaccompany theEnrollmentContract. Registration forms must be completed in full and submitted before your child will be confirmed for admission to FBCS.
GENERAL STUDENT INFORMATION
Current Age Level (2103-2014): Age Level Registering for in (2014-2015):
Student’s Full Name:
LastFirstMiddle
Date of Birth:Social Security Number: Sex: M F
Physical Address:
StreetCityZip
Mailing Address:
StreetCityZip
Home Phone: _Cell: Mother______Cell:Father______
EMERGENCY CONTACT INFORMATION
Person(s) to contact in case of emergency when parent/guardian cannot be reached:
Name: Relation to Student:
Address:
Home Phone:Cell:Work:
Name: Relation to Student:
Address:
Home Phone:Cell:Work:
PARENT/GUARDIAN INFORMATION
Father/Guardian
Full Name:
LastFirstMiddle
Physical Address:
StreetCityZip
Mailing Address:
StreetCityZip
Home Phone:Cell:Work:
Email:
Occupation/Position:Company:
Marital Status: Single: Married: _ Separated: Divorced: _ Widowed:__ _
Legal Guardian: Yes / No Living with Child: Yes / No Blended Family: Yes / No
Mother/Guardian
Full Name:
LastFirstMiddle
Physical Address:
StreetCityZip
Mailing Address:
StreetCityZip
Home Phone:Cell:Work:
Email:
Occupation/Position:Company:
Marital Status: Single: Married: _ Separated: Divorced: _ Widowed:__ _
Legal Guardian: Yes / No Living with Child: Yes / No Blended Family: Yes / No
CHURCH INVOLVEMENT
Are you a member of a church? Yes / No Do you attend worship services regularly? Yes / No
Church Name: Denomination:
Please state your reason(s) for wanting your child to receive a Christian education:
Please state your reason(s) for wanting your child to attend FBCS:
In order of importance, list what you consider to be the three most vital aspects of your child’s education (please be specific):
1.
2.
3.
HOW DID YOU HEAR / LEARN ABOUT
FIRST BAPTIST CHRISTIAN SCHOOL?
2014-2015 SCHOOL YEAR
Please check below:
RADIO ?
BILLBOARD ?
NEWSPAPER AD? Which newspaper?______
CHURCH ? Which church?______
A FRIEND? Who?______
WEBSITE? WHICH ONE, CHURCH OR SCHOOL ______
SIGNS? ______
OTHER? ______
Please check the areas below that impacted your decision to enroll your child at FBCS:
RECOMMENDATION BY A FBCS FAMILY
FBCS REPUTATION IN MARBLE FALLS
DISSATISFACTION WITH FORMER SCHOOL
WANTED CHRIST – CENTERED EDUCATION
LOCATION
CHILD DEVELOPMENT PROGRAM
ACADEMIC PROGRAM
ENRICHMENT PROGRAM
OTHER______
PARENT PERMISSION FOR PUBLISHABILITY OF DIRECTORY INFORMATION AND PHOTO PUBLISHABILITY
(CHILD DEVELOPMENT CENTER 2014-2015 SCHOOL YEAR)
If FBCS has not received this permission form back by August 30, 2014, FBCS will consider that FBCS has your PERMISSION TO PUBLISH DIRECTORY INFORMATION AND PERMISSION TO PUBLISH PHOTOS of your child
.
YES! I understand and APPROVE that First Baptist Christian School may publish DIRECTORY INFORMATION for my child. Directory information includes child’s name, parents’ names, addresses, and phone numbers.
I DO NOT give my consent to First Baptist Christian School to publish DIRECTORY INFORMATION for my child.
YES! I understand and APPROVE that First Baptist Christian School MAY USE PHOTOGRAPHS taken of my child for publication purposes (newsletters, magazine, videos, power points, brochures, other media, FBCS website, etc.) The photographs may be taken at FBCS campus or extracurricular activity.
I DO NOT give my consent to First Baptist Christian School to PUBLISH PHOTOGRAPHS of my child.
CAMPUS: CDC
STUDENT’S NAME ______
STUDENT’S AGE / GRADE LEVEL ______
PARENT/GUARDIAN’S NAME ______
SIGNATUR OF PARENT / GUARDIAN ______
DATE______
MEDICAL INFORMATION
Any medication given to student must be in the original container and kept in the administration office. The appropriate permission form must be filled out and signed by a parent/legal guardian.
Student Name:
Physician:Phone:
Hospital Preferred by Physician:Phone:
Medical Insurance Co.:Phone:
Policy Number:Group Number:
Dentist:Phone:
Hospital Preferred by Dentist:Phone:
Dental Insurance Co.:Phone:
Policy Number:Group Number:
Has student been diagnosed with any of the following:No*YesCurrent Medication/Info
Allergic Reactions (food, insect, medication): LIST BELOW
Heart Condition
Anemia
Asthma
ADD/ADHD
Seizures/Epilepsy – DATE OF LAST SEIZURE:
Scoliosis
Acanthosis Nigricans
Previous Surgeries
Mental or Physical Handicap
Glasses or Contacts
Visual Handicap: Left Eye / Right Eye / Both
Hearing Loss: Left Ear / Right Ear / Both
Hearing Aid
Ear Tubes
Other Medical Condition: LIST BELOW
*If you checked YES to ANY of the above conditions, please provide details (treatment, medication, inhalers, etc.):
Would any of the above conditions limit your child’s participation in our program? Yes / No
If yes, please explain:
Discipline and Guidance Policy for First Baptist Christian School
- Discipline must be:
(1)Individualized and consistent for each child;
(2)Appropriate to the child’ level of understanding; and
(3)Directed toward teaching the child acceptable behavior and self-control.
- A caregiver may only use positive methods of discipline and guidance that encourages self-esteem, self-control, and self-direction, which include at least the following:
(1)Using praise and encouragement of good behavior instead of focusing only upon unacceptable behavior;
(2)Reminding a child of behavior expectations daily by using clear, positive, statements;
(3)Redirecting behavior using positive statements; and
(4)Using brief supervised separation or time out from the group, when appropriate for the child’s age and development, which is limited to no more than one minute per year of the child’s age.
- There must be no harsh, cruel or unusual treatment of any child. The following types of discipline and guidance are prohibited:
(1)Corporal punishment or threats of corporal punishment
(2)Punishment associated with food, naps or toilet training
(3)Pinching, shaking or biting a child
(4)Hitting a child with a hand or instrument
(5)Putting anything in or on a child’s mouth
(6)Humiliating, ridiculing, rejecting or yelling at a child
(7)Subjecting a child to harsh, abusive or profane language
(8)Placing a child in a locked or dark room, bathroom or closet with the door closed
(9)Requiring a child to remain silent or inactive for inappropriately long periods of time for the child’s age.
Texas Administrative Code, Title 40, Chapter 746, Subchapters L, Discipline and Guidance
Grandparent Information:
Name of Grandparent: ______
Address ______
Email Address ______Phone Number ______
Name of Grandparent ______
Address ______
Email Address ______Phone Number ______
Name Grandparent: ______
Address ______
Email Address ______Phone Number ______
FBCS Annual CDC Enrollment Packet Revised 4/14/2014 1