Faith Family Kids, Inc.
dba
FAITH FAMILY ACADEMY
300 West Kiest Blvd., Dallas Texas 75224 - ph. 214-375-7682 – fax 214 –375-7681
701 Ovilla Road, Waxahachie, Texas 75167
– ph. 972-937-3704 – fax 972-937-5806
Application for Admission (Elementary/Middle/High School)
PLEASE ANSWER ALL QUESTIONS BELOW AND SIGN AT THE BOTTOM
Student’s Last Name
First Name Middle Name Generation (Jr. I, II, III) Social Security #
Date of Birth Age as of Sept 1, 2015 Grade Home Phone
Other Phone #’s
With whom does child reside?
Street Address
City State Zip
Mailing Address (If different)
City State Zip
Father’s Name
Place of Employment Business Phone
Mother’s name
Place of Employment Business Phone
1. If your child has documented history, in reference to TEC Chapter 37, Subchapter A, has your child ever been expelled, dismissed, suspended or refused admission to another public, private or charter school? Yes__ No__ Explain: ____________________________________________
2. If your child has documented history, in reference to TEC Chapter 37, Subchapter A, has child ever been assigned to an alternative program?
Yes____ or No ____ Explain: __________________________________________________________________
3. Does your child have any documented history of a Criminal offense?
Explain: __________________________________________________________________
4. If your child has documented history of a criminal offense has your child ever had disciplinary difficulties as defined by TEC Chapter 37, Subchapter A?
Yes____ or No ____
Explain: __________________________________________________________________
5. Has your child ever applied or been enrolled in Faith Family Academy? Yes ________ No_______
If so, when? ______________________________________________________________________
By my signature, I certify that the foregoing information is correct.
__________________________________________________________Date_____________
Parent or Guardian Signature
Disclosure Statements:
It is the policy of Faith Family Academy Charter School to comply with non-discrimination provisions of all federal and state laws. FFA admits students without regard to race, religion, color, gender, age, national origin, ethnicity, disability, academic, artistic, athletic ability, marital status, political belief, limited English proficiency or the district the child would otherwise attend.
FFA will deny admission to students with documented histories of a criminal offense, juvenile court adjudication, or discipline problems under TEC Chapter 37, Subchapter A. If anyone believes that they have been discriminated against, they should write to the Secretary of Education, Washington D.C. 20250.
Child Find - a free appropriate public education (FAPE) is provided to all individuals with disabilities, ages 4-21, who qualify for special education services. With the assistance of the Texas
Education Agency, ESCs, and the Early Childhood Intervention (ECI) program, LEAs must ensure that early intervention services are made available for those children, ages 0-3, with an identified need.
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Faith Family Kids, Inc. dba
FAITH FAMILY ACADEMY
300 West Kiest Blvd. -- Dallas Texas 75224
– ph. 214-375-7682 – fax 214-375-7681
701 Ovilla Road, Waxahachie, Texas 75167 – ph. 972-937-3704 – fax 972-937-5806
2015-2016 INFORMATION / CHECK LIST-WORKSHEET
Complete REQUIREMENTS * ALL STUDENTS
Student Enrollment Application
– COMPLETED IN FULL
Parent Agreement – Enrollment Information – Medical Form
Pick up List
– Home Language Survey – Telecomputing Network Use Agreement – etc.
Certified Birth Certificate – not hospital issued (bring original to be copied and returned)
Complete Shot Records (bring original to be copied and returned)
Social Security Card (bring original to be copied and returned)
Most recent Report Card/Transcript
Withdrawal Form from school if student is transferring during school semesters
“YEAR END” report card for previous year (2014-2015)/ Summer School if applicable
Copy of IEP if student is in Special Education
Utility Bill showing current address of residence
If your child drives to school, a copy of current insurance, driver’s license, license plate, make, model and color of vehicle will be required to be on file with FFA campus security
Meal Program Application must be completed returned and processed (one for each family). This is not available until the 1 st day the child attends school with the exception of Pre-K
If you are not the birth parent(s), you must provide documents showing you have custody
INFORMATION FOR PARENTS
Student’s School Supplies (must bring the 1 st day attending)
Uniforms MUST be worn from the 1 st day attending school
All Pre-K-12 students are required to comply to State attendance laws
Disclosure Statements:
It is the policy of Faith Family Academy Charter School to comply with non-discrimination provisions of all federal and state laws. FFA admits students without regard to race, religion, color, gender, age, national origin, ethnicity, disability, academic, artistic, athletic ability, marital status, political belief, limited English proficiency or the district the child would otherwise attend.
FFA will deny admission to students with documented histories of a criminal offense, juvenile court adjudication, or discipline problems under TEC Chapter 37, Subchapter A. If anyone believes that they have been discriminated against, they should write to the Secretary of Education, Washington D.C. 20250.
Child Find - a free appropriate public education (FAPE) is provided to all individuals with disabilities, ages 4-21, who qualify for special education services. With the assistance of the Texas
Education Agency, ESCs, and the Early Childhood Intervention (ECI) program, LEAs must ensure that early intervention services are made available for those children, ages 0-3, with an identified need.
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9 th *Algebra 1 *English 1 *World Geography *IPC
10 th *Geometry *English 2 *US History *Biology
11 th *Algebra 2/
Math Models
*English 3 *Government/Econ/World
History/Social Studies Research
Topics
*Government/Econ
*Chemistry/ Physics
12 th *Pre-Calculus/Algebra 2 *English 4
Elec. College Math OR
Statistics
Tech class
*PE /Health
*Spanish 1/2
*Prof comm. (speech)
*Anatomy &
Physiology/Forensic
Science
*Forensic Science/ Medical
Microbiology/
*Spanish 2/3
1 BEING THE CLASS YOU WANT MOST
Journalism Digital & Interactive
Media (DIM)
Advanced
Audio/Video
Production
Commercial Photography/
Advanced Commercial
Photography
Advanced
Animation
*Principles of Arts,
A/V &
Communication
Animation 1
*Theatre Arts
*Principles of
Hospitality &
Tourism
*Business
Information
Management 1 or
2 (BIMM)
Web Technologies
One Act Play
Dance 1 or 2
*Entrepreneurship
*Audio/Video
Production
Money Matters
*Principles of
Business, Marketing
*Athletics – which sport?
*Spanish 1/2/3
Choir
Business English
Accounting 1 or 2
*Art (1, 2, 3 – Circle One)
Business Law
*Political Science
1
*Sports Marketing
Human
Resources
Management
*Graphic Design &
Illustration
Touch System Data
Entry
* Yearbook
*Hotel Management
Arts & Humanities
 World Language
(Spanish) **
 History **
 Fine and
Performing Arts
Business & Industry
 Career Technical Education
 Arts/Audio/Video Technology**
 Business Management & Administration**
 Hospitality & Tourism **
 Information Technology **
 Marketing
 English
Multidisciplinary
 (A) Advanced **
 (B) Core 4 X 4 **
STEM
 Science
 Math
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Faith Family Kids, Inc. dba
FAITH FAMILY ACADEMY
300 West Kiest Blvd., Dallas, Texas 75224
– ph. 214-375-7682 – fax 214-375-7681
701 Ovilla Road, Waxahachie, Texas 75167 – ph. 972-937-3704 – fax 972-937-5806
ENROLLMENT STUDENT PERSONAL INFORMATION
Last Name (As on Birth Certificate.)
School year: ____________Date:___________
Social Sec. No.
First Name (As on Birth Certificate)
Middle Name (As on Birth Certificate)
Preferred Name
Generation (Jr,I,II)
Birth date Birth place
Gender(male-female)
Home Language
Grade (2014-2015)
Foster Child?
YES NO
Home Phone #
Ethnicity (circle one): Black Hispanic Anglo Asian Native American
Student lives with (Name): Relationship:
Street Address:
City State Zip
Mailing Address (if differs)
City State Zip
Name of Local Public School Campus/District this student would attend if not attending any Charter School or private school:
List last 3 schools attended (at least list the last 3 years) and dates/grades while attending the school. ( If more than 3 please use back of sheet).
School District City Grades/Dates of Attendance School Name
Please list all siblings that are/will be attending Faith Family Academy:
_____________________________________________________ _______________________________________________________
_____________________________________________________ _______________________________________________________
_____________________________________________________ _______________________________________________________
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ENROLLMENT STUDENT PERSONAL INFORMATION cont.
S tudent’s Name ____________________________________________ Grade 2015-2016 _______________
1 st CONTACT (Parent, Guardian, Other)
E-mail address Last Name
First Name
Relationship
Parent ID/Driver ’s License #
Employer & Address
Custody (circle one) yes no
Street Address
City/State/Zip
Mailing Address
City/State/Zip
Work E-mail
Home Phone
Mobile Phone
Last Name
First Name
Relationship
2 ND CONTACT (Parent, Guardian, Other)
E-mail address
Parent ID/Driver ’s License #
Employer Name and Address
Custody (circle one) yes no
Street Address
City/State/Zip Work E-mail
Mailing Address Home Phone
City/State/Zip Mobile Phone
Please indicate academic level of child’s previous work: 90-100_______ 80-90_______ 70-80_______ below 70_______
Has child ever failed in school? Yes______ No______ When? ________________ Where? ______________
Explain: _________________________________________________________________________________
Has your child attended Summer School? Yes______ No______ When? ___________ Where? ___________
Explain: _________________________________________________________________________________
Has your child ever been in Special Education or Section 504? Yes_____ No_____ When? ______________
Explain:_________________________________________________________________________________
What was the last school your child was in a Special Education Program? ____________________________
Has your child ever been in a Gifted and Talented Program? Yes_____ No_______ When?_______________
Has child ever been eligible for a public education grant (PEGS)? Yes_______ No_______ When? ________
Explain: _________________________________________________________________________________
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Faith Family Academy
Home Language Survey
Student’s Name__________________________________________________________________________
Nombre del estudiante Last/Apellido First/Nombre Middle/Segundo Nombre
Date of Birth________________________________________________ IDS_________________________
Fecha de nacimiento Month/Mes Day/Dia Yeat/Aho
School__________________________________ Grade__________ Date Enrolled___________________
Escuela Grado Fecha de entrada
Home Language Survey (informacion sobre el idioma quo se habla en casa)
1. What language is spoken in your home most of the time? _______________________________________
Cual es el idioma que mas se habla en su hogar?
2. What language does your child (do you) speak most of the time? ________________________________
Cual es el idioma que su Nino(a) habla mas?
3. What language did your child learn to speak first? ____________________________________________
Cual es el idioma que hijo(a) aprendio primero?
4. Where is your child’s place of Birth? (Country) _______________________________________________
Pals natal de nacimento?
5. Has your child lived outside the U.S. for two (2) or more consecutive years? Yes/Si _______ No______
Ha residido su hijo(a) fuera de los Estados Unidos por mas de dos (2) anos consecutivos?
6. Did your child attend school when residing outside the U.S.? Yes/Si ______ No _______
Asistio su hijo(a) a la escuela mientras estuvo fuera de Los Estados Unidos?
7. Has your family moved during the last three years from one school district to another in the state of Texas
or across states? Yes/Si ______ No _______
Se ha movido su familia durante los ultimos tres anos de un distrito escolar para otro en el estado de Tejas
6 a traves de todos los Estados Unidos?
8. Was this move due to the need to find temporary or seasonal work in agriculture or related areas such as
packing, processing, harvesting, crop, dairy produce, fishing, forest work, etc.? Yes/Si ______ No _______
fue la razon de su movimiento para buscar trabajo temporal de estacion en agricultura, o en areas
relacionadas para empacar, procesar, recoger producto de cosecha, productos lacteos, de pescaderia,
O de trabajos forestales?
Date of FIRST entry into ANY school in the U.S.A.
_________________________________________________
Fecha de PRIMER ingreso en CUALQUIER escuela en los Estados Unidos.
Grade/Grado ______________ Month/Mes ___________________________________Year/Aho__________________
Signature of Parent __________________________________________________________ Date ________________
Firma del Padre/Guardian Fecha
White-Cumulative Folder ALL Yellow-ESL/Bilingual Department
SST-130 2/13/2006
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