APPLICATION FOR ADMISSION A parent r guardian must cmplete all infrmatin with the exceptin f the applicant s essay. Please place an X in the bx next t the schl fr which yu are applying and print legibly in ink. [] Nevada Primary Schl Grades Preschl 5 Detrit, MI 48234 (313) 892-1860 ext. 243 (Please cmplete ONE APPLICATION fr EACH CHILD and check nly ne bx) [] Nevada Middle Schl Grades 6 8 Detrit, MI 48234 (313) 892-1860 ext. 224 [] Leadership & Business High Schl Grades 9-12 Detrit, MI 48234 (313) 892-1860 ext. 292 PLEASE PRINT NOTE: Student must be f age by September 1 st t be enrlled in desired grade. Date: Applying t Grade: Applying Fr Schl Year: 1. STUDENT INFORMATION: M F (Student s Last Name) (Student s First Name) (Middle Initial) (Check ne) Hme address: Date f Birth: / / (Number and Street) (City) (Zip Cde) (Mnth Day Year) Name f Current Schl: Current Grade: Street Address f Schl: City: State: Zip: Telephne Number: Fax#: Fr Preschl thrugh 12 th grade, attach Birth Certificate & Immunizatin Recrd. Fr 1 st thrugh 12 th grades, attach the abve plus last tw (2) years Reprt Card if pssible. Fr 1 st thrugh 12 th grades, include three letters f recmmendatin n behalf f the student. Fr 3rd thrugh 12 th grades, attach a student essay n why yu shuld be admitted t Crnerstne Schls. A parent essay must be included with each applicatin Preschl thrugh 12 th grades, n behalf f the child. 1. Has yur child ever been Suspended? Expelled? Asked t withdraw? 2. If any f the abve is true, please explain n a separate sheet f paper, including the name and address f the schl. 3. Has yur child ever applied t r been enrlled at any f the Crnerstne Schls? [] Yes [] N If s, please explain n a separate sheet f paper which campus and the reasn fr leaving. 4. Des yur child have any special academic/medical needs? [] Yes [] N Please explain n a separate sheet f paper. 5. Des yur child have an Individualized Educatin Plan (IEP)? [] Yes [] N Please attach a cpy with this applicatin. 6. Are there any reasns including medical that may prevent yur child frm participating in CSA s [] Yes [] N physical educatin (PE) prgram? If yes, please prvide supprting dcumentatin. SM F 7.1200 Crnerstne Schls Assciatin page 1 f 5 Release date: 5/18/05 Issue: #12 Revisin date: 02/26/16
2. FAMILY INFORMATION: Mther / Legal Guardian: (Last Name) Relatinship t Student if ther than Mther: (First Name) Address: (Number and Street) (City) (Zip Cde) Telephne # ( ) ( ) ( ) (Hme) (Wrk) (Cell Phne) Emplyer: (Name & Address) Telephne: Psitin: Wrk Schedule: Highest Level f Educatin Cmpleted: Email Address: _ Father / Legal Guardian: (Last Name) (First Name) Relatinship t Student if ther than Father: Address: (Number and Street) (City) (Zip Cde) Telephne # ( ) ( ) ( ) (Hme Phne) (Wrk Phne) (Cell Phne) Emplyer: (Name/Address/Telephne) Psitin: Hurs: Highest Level f Educatin Cmpleted: Email Address: _ Wh is the legal guardian? Name and address f persn(s) respnsible fr financial cmmitment (if ther than Parent/Legal Guardian): Name: Telephne#: (Area Cde & Number) Hme address: (Number and Street) (City) (Sate) (Zip Cde) Please check which f the fllwing is crrect: Child lives with: [] Father [] Mther [] Bth Parents [] Guardian [] Other (please name) Please explain the family pattern and legal custdy if the applicant des nt live with bth parents in the same husehld SM F 7.1200 Crnerstne Schls Assciatin page 2 f 5 Release date: 5/18/05 Issue: #12 Revisin date: 02/26/16
Family Members: (If there are ther children in yur family, please cmplete the fllwing) Name Gender Age Schl Grade Hw Did Yu Hear Abut Crnerstne Schls Assciatin? (Please check ne): [] Family / Friend [] Current Student [] Cmmunity Event [] Direct Mail [] Website / Internet [] Church Annuncement [] Newspaper [] Radi / TV Ad [] Billbard [] Other (please name) Church Affiliatin r Name f Church: Extracurricular Activities: Academic Club: Cmmunity Service Prjects: Athletics: Drama / Music: Hbbies: Admissins Plicy: Crnerstne Schls Assciatin is a Christ-centered cllege preparatry schl in the Crnerstne traditin. The schl welcmes students withut regard t race, religin, clr, natinal r ethnic rigin t all the activities, prgrams, privileges and rights ffered within its peratin. Parent (r Legal Guardian) Statement: In making applicatin fr my child t attend a Crnerstne Schl, I attest that all f the infrmatin n this frm is true t the best f my knwledge. I agree t supprt the Parent Cvenant, Parent/Student Handbk, and the philsphy and plicies f Crnerstne Schls Assciatin (CSA). I understand that every student is expected t bey the rules f the CSA and that the CSA reserves the right t dismiss a student, as stated in the Parent/Student Handbk. It is understd that the signature f ne f tw parents r guardians implies the cnsent f the ther. Date Parent / Guardian Signature Date Parent / Guardian Signature Please inquire regarding tuitin assistance. SM F 7.1200 Crnerstne Schls Assciatin page 3 f 5 Release date: 5/18/05 Issue: #12 Revisin date: 02/26/16
STUDENT ESSAY Date: Applying t Grade: Date f Birth: Applying Fr Schl Year: M F (Student s Last Name) (Student s First Name) (Middle Name) (Check ne) 1. Why d yu lve Jesus? 2. Why d want t attend Crnerstne Schls? 3. What d yu want t gain frm attending a Christ-centered schl? SM F 7.1200 Crnerstne Schls Assciatin page 4 f 5 Release date: 5/18/05 Issue: #12 Revisin date: 02/26/16
PARENT ESSAY Date: Applying t Grade: Date f Birth: Applying Fr Schl Year: M F (Student s Last Name) (Student s First Name) (Middle Initial) (Check ne) OUR VISION We see transfrmed lives, fr gd; and a new city fr all. OUR PHILOSOPHY We believe all children are created in the image and likeness f Gd and we are endwed by their Creatr with inalienable rights and abundant purpse. We believe an excellent educatin begins with parents, a child s first teachers. They nurture the unique ptential and destiny f their child and, by gd example, encurage a life filled with the jy f learning, gd deeds, and right cnduct. We believe an excellent educatin is furthered by gd teachers, administratrs, staff, and partners within a learning cmmunity which makes it pssible fr a student t realize his r her ptential in life. An excellent educatin encurages a student t seek truth, t knw lve, t develp a disciplined mind and a wise, kind, curageus, jyful, and discerning heart; t serve numbly, t respect and wrk with thers; t pursue excellence, t develp gd judgement, t seek what is gd, t d what is right, and t accept respnsibility fr ne s actins. We believe an excellent educatin equips a student t understand and appreciate the persn and teachings f Jesus. An excellent educatin als includes literature, the fine arts, gegraphy and the sciences; mathematics, grammar, writing, language and the spken wrd; technlgy, histry and cultures, particularly American histry; and the rich and diverse cntributins f many t it; cupled with the idea and practice f freedm, self-gvernment, equality, citizenship, leadership, free markets, business enterprises, and vluntary assciatins. OUR MISSION Our brad and belved cmmunity f friends will make pssible an excellent educatin fr children s as t prepare them fr life and leadership. On this jurney we will seek t fllw Jesus as a sure path t a fulfilling life and servant leadership. T read the visin, philsphy and missin f Crnerstne; as a parent, what d yu expect yur child t learn in a Christ-centered schl? SM F 7.1200 Crnerstne Schls Assciatin page 5 f 5 Release date: 5/18/05 Issue: #12 Revisin date: 02/26/16