2024年3月27日发(作者：爱思助手ios版下载正版)

_______________________________________________ ____________________ ________________

Student’s Name Grade Applying School Year

Abilene Christian Schools seeks to ensure an atmosphere

in which students can grow in wisdom, in stature,

and in favor with God and man.

Abilene Christian Schools seeks development of moral excellence,

knowledge, self-control, perseverance, godliness,

brotherly kindness, and love.

Return the completed Application Form and Records Release Form. Complete the Student Background

Survey and give it to your student’s present or last school principal/head of school.

2550 N. Judge Ely Blvd.

Abilene, TX 79601

325/672-9200, Ext. 21 ● 325/672-1262 (fax)

APPLICANT DATA

Student's Name:

Complete Address:

Date of Birth:

Student Cell Phone: ( )

Current School:

Previous School:

Applicant lives with: Mother

Father

Stepmother

Stepfather

Age:Gender:

Student SS#:

Years of attendance:

Years of attendance:

Legal Guardian

Other:

Hispanic

Asian

Caucasian

Other:

Church of Christ

Other:

Home Phone: ( )

Preferred Name:

Ethnic Background:African-American

American Indian/Eskimo

Baptist

Methodist

Religious Preference:

Congregation:

Church Attendance:

Catholic

Non-Denominational

WeeklyOccasionally

yes

yes

Billboard

Newspaper

Referred by:

yes

Never

no

no

Participates in youth group

Has student attended ACS in the past?

Is family member an ACS alumnus?

How did you hear about ACS?

If yes, dates of attendance:

Name & relationship:

Magazine AdWebsite

Other

I am interested in After School Care:No

HEALTH AND ACADEMIC HISTORY

Name and explain any health condition(s), past or present, which need to be brought to the school's attention to

safeguard this applicant at school or which would restrict physical activity levels. (For example, diabetes, seizures,

asthma, behavior disorders, educational challenges, etc.)

If yes, please list:

Is the applicant taking any prescription medication(s)?

If yes, please list:

yesNo

Has the applicant been tested or has testing been recommended for any of the following?*

Attention Deficit Disorder w/ or w/out hyperactivityLearning Differences

Behavioral/Emotional issues:Dyslexia

Other:Speech/Language

*If tested, please indicate date and diagnosis/conclusions:

*Please provide test reports/conclusions for applicant file.

Doctor's Name: Phone: ( )

*Student Health Information Form must be completed for school nurse*