Lighthouse CHRISTIAN academy Offering parents a choice and children a chance 2920 Lake Arthur Drive, Port Arthur, Texas 77642 Phone (409) 729-6000 Fax (409) 724-2469 Application Process for New Students Dear Parents, We are most honored that you are considering Christian education as an option for your child. We look forward to joining you in the awesome privilege of educating your child. Lighthouse Christian Academy is an extension of the home, closely working with parents to train the child. Your child will receive both high academics and traditional values training. The goal of this academic institution is to train children in the highest principles of moral character, self-discipline, individual responsibility, personal integrity, and good citizenship. In order to start the admissions process for your child, the forms listed below should be completed and returned to the school office. The school must receive all paper work and appropriate fees before an interview will be scheduled with the principal. Thank you for considering Lighthouse Christian Academy. We look forward to meeting with you as we discuss the academic future of your child. If you have any questions please feel free to call the school office. Steps for the Admissions Process 1. Review all LCA informational materials and pray 2. Complete Enrollment Application and submit all supporting material 3. Schedule a time for the Entrance Exam (for students entering 1 st 12 th grades) 4. Schedule Family Interview (all family members should plan to be present) 5. Receive Acceptance Letter/Phone call 6. Pay Registration Fees 7. Attend Parent Orientation Meeting Page 1 of 14
Admissions Checklist All forms, beginning with this page, must be turned in before an interview will be scheduled and before admissions will be completed. Student Application Form (accompanied by the following) Copy of Birth Certificate Copy of Immunization Records Pastoral or Personal Letter of Recommendation Last Report Card and copies of standardized testing Completed Student Questionnaire (page 8) Signed copy of the Student Contract (page 10) Signed copy of the Student & Parent Acknowledgement of Full Disclosure (page 10) Signed Acknowledgement of Receipt and Understanding of School Handbook (page 11) Signed and completed copy of the Transcript Release Authorization (page 12) Signed copy of My Commitment to Lighthouse Christian Academy (page 14) Note Completion of this application does not assure enrollment, but provides information upon which a decision is based. This application is the first step in the admissions process. Nondiscrimination Policy Lighthouse Christian Academy admits students of any race, color, nationality, and ethnic origin to all rights, privileges, programs, and activities made available to students at the school. It does not discriminate on the basis of race, color, nationality, and ethnic origin in administration of its education policies, admission policies, and other school administered programs. Affirmation I hereby affirm that all of the information contained in this application is true and accurate to the best of my knowledge. I understand that providing any false information would be sufficient reason for the rejection of this application. I further understand that I may be asked for additional written affirmation concerning such items as academic records. I hereby acknowledge that I have read the preceding agreements and have agreed to comply with each of their requirements as stated. Image Release The school engages in several advertising opportunities. Videos and pictures may be used on TV, the internet and printed copy. Recognizing that for privacy reasons some may wish that the student not be a part of pictures or videos. It is your responsibility to speak with your student(s) if you do not wish for the image of your child(ren) to be used in this manner and it is the student s responsibility to remind the LCA staff and to remove themselves from the video or picture. I, hereby, acknowledge the statements under the Nondiscrimination, Affirmation and Image Release sections. Signature Date (Parent or Guardian) Page 2 of 14
All Fees are Non-refundable Fees & Tuition Payment Plans for 2015 2016 For New Students New Student Application Fee (PK3 12 th grade) $100 (Due at the beginning of the Application process) New & Returning Student Enrollment Fee is due before the first day of class. PK 3 - PK 4........................ $300 K 6 th.......................... $400 7 th 12 th......................... $500 Athletic Fee (Due before participation in first sport) $100 Multiple Children Discount Multiple Child Discount: 2 nd Child (Applied only to tuition)............ $200 Multiple Child Discount: 3 rd Child (Applied only to tuition)............ $400 (Multiple Child Discounts cannot be applied in addition to other discounts or scholarships. The 1 st Child is the oldest child.) Payment Plans Single Payment Plan Grade Total Tuition Due On or before 8/4/15 PK3 PK4 Half Day (Optional) $3,000 PK3 PK4 Full Day $4,000 K 6 th Grade $4,500 7 th 12 th Grade $5,200 Two Payment Plan Grade 1 st Payment Due 2 nd Payment Due Total On or before 8/4/15 On or before 12/1/15 Tuition PK3 PK4 Half Day (Optional) $1,550 $1,550 $3,100 PK3 PK4 Full Day $2,050 $2,050 $4,100 K 6 th Grade $2,300 $2,300 $4,600 7 th 12 th Grade $2,650 $2,650 $5,300 Ten Payment Plan Grade Payments Due Number of Total On or before 1 st of each month Payments Tuition PK3 PK4 Half Day (Optional) $330 10 $3,300 PK3 PK4 Full Day $430 10 $4,300 K 6 th Grade $480 10 $4,800 7 th 12 th Grade $550 10 $5,500 Page 3 of 14
APPLICATION FOR ADMISSION TO LIGHTHOUSE CHRISTIAN ACADEMY 2920 Lake Arthur Drive, Port Arthur, TX 77642 Phone: 409-729-6000 option 2 Web: www.lcasetx.com Applicant Name: First Middle Last (Please print name exactly as it should appear on permanent records.) Preferred Name Male Female Applicant s Social Security # Home Street Apt # City State Zip Phone (H) Student Cell E-Mail Applicant s Date Birth Country of Birth Citizenship Current Grade Applying to Grade Year Present School Years of Attendance Public Parochial Private Home School School Street City State Zip Has applicant ever repeated a grade? Yes No Father or Male Guardian Name Social Security # - - Address City State Zip Phone (H) Cell Phone (W) E-Mail Employer Profession/Position Address City Mother or Female Guardian Name Social Security # - - City State Zip Phone (H) Cell Phone (W) E-Mail Employer Profession/Position City Page 4 of 14
Check any that apply: Father Deceased Mother Deceased Parents Separated Parents Divorced Student lives with? Father & Mother Father Mother Guardian Stepfather Stepmother Other May send mail to? Father Mother Guardian Other Legal custody? Father Mother Guardian Other Financial responsibility? Father Mother Guardian Other Is there any medical condition or other reason that the applicant cannot participate fully in any normal school activities, including athletics or co-curricular activities? Yes No If yes, please explain. Are there any special factors, conditions, learning differences, including any special medications or allergies, affecting your child about which the school needs to be informed? Yes No If yes, please explain. How did you learn about Lighthouse Christian Academy? (Please provide names where possible. Check all that apply) Alumnus Minister Guidance Counselor or Teacher Current Student or Parent Billboards Brochures Neighbor Realtors Newspaper Yellow Pages Radio/TV Chamber of Commerce Other Does the applicant have any relatives that currently/previously attend the school? Yes No If yes, please list names and years in attendance. Does the applicant have any siblings? Yes No If yes, please complete. Name Grade School Name Grade School Name Grade School Place of Worship Phone City State Zip How long have you attended? How often to you attend? Page 5 of 14
Grandparents Information Paternal Grandfather Name Address City State Zip Phone (H) Cell Phone (W) E-Mail Employer Profession/Position Address City Paternal Grandmother Name City State Zip Phone (H) Cell Phone (W) E-Mail Employer Profession/Position City Maternal Grandfather Name Address City State Zip Phone (H) Cell Phone (W) E-Mail Employer Profession/Position Address City Maternal Grandmother Name City State Zip Phone (H) Cell Phone (W) E-Mail Employer Profession/Position City Page 6 of 14
Paternal Step-Grandfather Name Address City State Zip Phone (H) Cell Phone (W) E-Mail Employer Profession/Position Address City Paternal Step-Grandmother Name City State Zip Phone (H) Cell Phone (W) E-Mail Employer Profession/Position City Maternal Step-Grandfather Name Address City State Zip Phone (H) Cell Phone (W) E-Mail Employer Profession/Position Address City Maternal Step-Grandmother Name City State Zip Phone (H) Cell Phone (W) E-Mail Employer Profession/Position City Page 7 of 14
STUDENT QUESTIONNAIRE GRADES 1 12 Students in grades 1 5 may need some assistance completing this questionnaire. However, students in grades 6 12 should complete this questionnaire in his/her own handwriting without assistance from anyone: your parents, your teacher or your friends. Submit the questionnaire with the Application for Admission. Applying to grade Beginning Fall 20 Male Female Print Full Name Age next September 1 st Years Months Names of brothers and their ages: Names of sisters and their ages: Fathers/Guardian s Name Mothers/Guardian s Name Home Address E-Mail Address (if applicable) Name of present school Your present grade level List your present subjects and give your lasted report card marks: List other schools you have attended and include which grade level(s) Page 8 of 14
Do you attend a local place of worship? (If yes, give name) Yes No How long have you attended? How often do you attend? What are your thoughts on attending a Christian school that promotes a college preparatory culture of education excellence wherein young men and women are trained spiritually, academically, physically, and artistically to reach their God-given destines? Briefly share your salvation experience Do you accept the Bible as God s Word and submit yourself to its principles as the final authority? Yes No Do you smoke? Yes No Have you ever smoked? Yes No Do you drink alcoholic beverages? Yes No Have you ever used narcotics of any kind? Yes No Have you ever been expelled or suspended from school? Yes No If yes, why? Will you promise not to draw, wear, or display in any way Anti-Christian symbols? Yes No In accordance with scripture, will you agree to dress in public according to modesty standards, being a consistent daily example, and not wear immodest clothing? Yes No In accordance with scripture, will you honestly agree to keep all the school rules and respect authority without being critical and finding fault? Yes No Page 9 of 14
Student Contract This student contract should be discussed by the family, signed by the student and co-signed by a parent/guardian. As a student of this school, I pledge to uphold this school s rules and guidelines stated in the school handbook. I will maintain behavior which exemplifies courtesy, kindness, morality and honesty. I will strive to be of unquestionable character in dress, conduct and other areas of my life. I agree to abide by the above standards of conduct and other regulations expected of each student enrolled in this school. I will not give the impression to other students, parents or faculty that I am not in harmony with the goals, aims and standards of the school. I have been truthful in answering all questions on the student questionnaire. I acknowledge that if it is found that I have not been truthful I will be subject to immediate and permanent expulsion. Student Signature Parent/Guardian Signature Date Student & Parent Acknowledgement of Full Disclosure In order to better serve your child, we need to know if there have been any experiences that will influence the community life at LCA. This includes such things as suspensions, expulsions, psychiatric care, substance abuse, or any other behavioral problems at home or at school. Please note on a separate sheet any situation(s) that could influence your child s experience at Lighthouse Christian Academy. Failure to notify us could result in your child s separation from the school. Please check one of the statements below. I HAVE attached documentation of situations that could influence my child s experience at LCA. I HAVE NOT attached documentation and declare that there are no situations that could influence my child s experience at LCA. Parent or Guardian Signature Student Signature Date Page 10 of 14
Acknowledgement of Receipt and Understanding of School Handbook and Standard of Student Conduct of Lighthouse Christian Academy By signing this instrument, I acknowledge that I have read and understand the Standards of Conduct of Lighthouse Christian Academy, as set out in the Student Handbook, and agree that my child must and will abide by them both at and away from school functions. I agree to fully support the school in its enforcement of the Standards of Conduct. As Lighthouse Christian Academy is a Christian ministry organization, I agree not to make demands, threaten to sue, make any kind of accusation or complaint, or bring litigation against Lighthouse Christian Academy or its staff, regarding any matter whatsoever relating to or resulting from the enforcement of the Standards of Conduct, and agree to hold Lighthouse Christian Academy and its staff harmless regarding any matter related to same. To do otherwise would be a clear violation of Biblical teaching and practice. I recognize that Lighthouse Christian Academy has a qualified, trained staff, and I have confidence in their abilities and discretion to perform the educational functions due my child. Lighthouse Christian Academy recognizes that it cannot meet the educational needs of all children. It is a school offering high quality character training, but it is not designed to be a correctional institution for problems arising beyond those usually encountered in average school children. While we love delinquent and emotionally volatile children, the school is not equipped to meet their specialized needs. Some children do not adjust to a disciplined academic environment, and find excuses to criticize the policies and decisions of staff and administration. In such cases, the school reserves the right to have full discretion in discipline, to place such students on probation for a reasonable corrective period of time, and to dismiss any student who does not cooperate with the total educational process. Lighthouse Christian Academy reserves the right to dismiss a student, at the sole discretion of the School, for any reason deemed necessary, including but not limited to disciplinary problems, failure to adhere to School policy, and failure to meet the financial obligations set out in the tuition fee schedule. I recognize that, from time to time, children take issue with actions with which they do not agree and are prone to criticize statements out of context. Since this is normal of children, I pledge that, should such occur, I will support the school personnel and call them for further details when I have a question concerning an incident. I further realize that building strong relations with my child s supervisor in order to help in the training of my child is as much my responsibility as it is the School s. I will pray for the staff and program, cooperate with them in discipline and accept their judgment in such matters, lay a spiritual foundation through a Godly example in our home, support the school s character training, follow through with any work, assignments, or slips to be signed, see that my child arrives at school on time, send written excuses for absence or tardiness, cooperate in training my child to respect school property and pay for abuse of the same, attend all parent functions, and assist in positively publicizing the school and its program among friends. I realize it is a privilege and not a right for my child to attend Lighthouse Christian Academy. It is my intention to abide by the decisions and support the discipline of the administration. I acknowledge that I have read and understand the foregoing, that I have been given an opportunity to ask questions and have them answered, and that I am signing this document of my own free will. Date: Parent or Guardian Signature: Second Parent Signature: Name of Student(s): Page 11 of 14
Lighthouse CHRISTIAN academy Offering parents a choice and children a chance 2920 Lake Arthur Drive, Port Arthur, Texas 77642 Phone (409) 729-6000 Fax (409) 724-2469 TRANSCRIPT RELEASE AUTHORIZATION To Principal or Guidance Counselor: My child is an applicant for admission to Lighthouse Christian Academy. I hereby authorize you to release any records needed by LCA which include but may not be limited to the following: a certified copy of the complete transcript (including grades, credits, and all standardized test results), immunization, and health records (including hearing, spinal and vision if available). Name of Student Date Current Grade Level Name of current school School phone Registrar Email Address Signature of parent Confidential Evaluation (to be completed by the school s Principal or Guidance Counselor) Name of Principal or Guidance Counselor In what capacity and for how long have you known this student? Please comment on the student s attitude toward school: To your knowledge, has the student had any involvement with drugs, alcohol, or juvenile delinquency? Yes No Page 12 of 14
Has the student ever been suspended? Yes No Expelled? Yes No If yes, please explain: To your knowledge, has the student had any history of conduct or behavior problems? Yes No If yes, please explain: Does the student have a history of learning disability? Yes No Does he/she require special assistance to meet academic requirements? Yes No If yes, please explain: Attendance: Additional comments, if needed: Signature Date Page 13 of 14
My commitment to Lighthouse Christian Academy (Please read the following statements of commitment, sign, date and return with the enrollment application.) I have read the school s Statement of Faith and understand its foundational philosophies. I understand that the school program is an integral part of child training of which I am expected to support. I hereby commit to assume my Scriptural responsibility for financial support of the school. I hereby commit to pay all fees and tuition in a timely fashion. I understand that my child is expected to take part in school activities, including P.E., fundraisers, and sponsored trips away from the educational facility, and I absolve the school from liability to me or my child because of injury to my child at properly supervised school activities. I agree to uphold and support the high academic standards of the school by providing a place at home for my child to study and by encouraging my child in the completion of any homework or assignments. I appreciate the standards of the school and will not tolerate profanity, obscenity in word or action, dishonor to the Godhead or the Word of God, or disrespect to the staff of the school. I hereby agree to support regulations published in the school handbook and authorize the school to employ discipline as it deems wise and expedient for the training of my child. I agree to abide by the standards of the school and other regulations expected of each family enrolled. I will not give the impression to students, other parents or faculty that I am not in harmony with the goals, aims and standards of the school. I understand the school reserves the right to dismiss any child who fails to comply with established regulations and discipline or whose parents do not assume their responsibilities to the school. I agree that in the event I wish to withdraw my student(s) from the school I will contact the school administration as early as possible before the withdrawal date. That I will complete the withdrawal checklist to the satisfaction of the school administration and that no student record will be released to me or any future school until all fees and fines have been paid, including tuition payable up through the date of withdrawal. I have read and understand the terms stated on this contract. Signature of Father/Guardian Date Signature of Mother/Guardian Date Print name Print name Page 14 of 14