Enroll - Shiloh Christian Academy

Student Age* (as of September 1st of the upcoming school year)

Student Birth Date*

What grade is your scholar entering?*

Student First Name*

Student Last Name*

Street Address*

City*

State*

Zip Code*

Legal Parent/Guardian 1*

Relationship to Student*

Phone Number*

Email Address*

If home address is different from student, please enter below:

Occupation*

Current Employer*

Current Employer Address*

Legal Parent/Guardian 2:

Relationship to Student

Phone Number

Email Address

If home address is different from student, please enter below:

Occupation

Current Employer

Current Employer Address

Emergency Contact*

Emergency Contact Phone Number*

Relationship to Student*

Previous School 1*

Type of School*

Previous School 2

Type of School

Has your child had any attendance or tardiness concerns?

Yes No

Has your child ever been retained?

Yes No

Has your child ever been skipped a grade?

Yes No

Has your child ever been suspended, expelled, or had any on-going behavior concerns?

Yes No

If you answered yes to any of the questions above, please provide a description of the circumstances and any additional information that will be helpful to the SCA admissions team. Answering yes just gives us more information to understand your scholar's needs and is not a sole determinant in admission decisions. If you answered no to all of the questions, please type N/A.

What are your scholar's academic strengths?

What are your scholar's academic challenges?

What honors or academic awards or achievements has your scholar received?

Describe your scholar's hobbies, interests, and/or special talents.

If you checked Special Education, do you have your scholar's special education records including the most recent IEP?

If you checked 504 Plan, indicate if the plan is for academic or health reasons:

Please upload the following documents or email them to info@shilohchristiansaints.org. Appllications are not considered complete until payment and alll documents are received. Required Documents: Current Report Card, All Disciplinary Records, Copy of IEP, Most Recent Standardized Testing Results

Truthful Information

My e-signature below affirms that all of the information contained in this application is correct, complete, and honestly presented. I understand that withholding information or misrepresenting information in this application may jeopardize my scholar's admission.

Release of Records

I waive my right to access confidential information contained in my scholar's admission file.

First Name

Last Name

Date

How did you hear about Shiloh Christian Academy?

Please enter any additional comments related to your scholar's application.

Shiloh Christian Academy - Atlanta