Registration

Student Information
* Registration Type:	New Registration Renewal
* Student's Last Name:
* Student's First Name:
* Birthday:
* Age:
* Gender:
* Has student had any academic, physical and/or learning disabilities or problems?	Yes No
If yes, please explain:
Academic Information
* School Year:
* Grade:

Academic Records
* We give permission to have our student's record requested from their previous school?
* Previous school year:	Public Private Homeschooled independently: If so, you will need to send NCCS your student’s academic records, a copy of their birth certificate, a copy of up to date immunization record.
* Previous School:
* Mailing Address:
* City:
* State:
* Zip:
* Phone:
Fax:
* Has your student ever been suspended, expelled or charged with truancy?	Yes No
If yes, please explain:

Family Information
* Father's Full Name:
* Father's Place of Employment:
* Mother's Full Name:
* Mother's Place of Employment:
* Family Street Address:
* City:
* State:
* Zip:
International Address:
* Phone:
Cell Phone:
* Email: Email is mandatory for enrollment in NCCS
* With whom is the student currently living?
* Who is the student’s legal guardian? Please note: If the student does not reside with both parents listed on the student’s birth certificate the parent or legal guardian must provide documentation of custody by an appropriate state agency.
* Church family attends (name and city):
HSLDA Information
* Do you hold Home School Legal Defense Association membership?	Yes No
If yes, what is your HSLDA membership #?
If yes, date HSLDA membership expires:	mm/dd/yyyy
* Is your family listed with another organization’s Group Discount?	Yes No
If yes, name of group:
If yes, Group Discount #:
Faculty Information
* Who will be the primary teacher, at home with the student, during school hours?
* High School education?	Yes No
* High School attended:
* City:
* Last year attended:
* College education?	Yes No
If yes, college attended:
If yes, college city:
If yes, college degree:
If yes, teaching credential?	Yes No
* List teaching experience:
* List teacher training or other education related training:

Parental Responsibility Agreement
North County Christian School requires both parents to agree to and follow through with these responsibilities in teaching their children at home. Read through this agreement, sign & date.
	We will apply to HSLDA for membership OR we will renew our HSLDA membership each year that we are enrolled in NCCS.
	We will provide curriculum for student in compliance with state guidelines for subjects to be taught.
	We understand the importance of accurate record keeping and agree to maintain a daily lesson plan book that records what was accomplished in each subject and we will keep these records for, at least, a two year period.
	We understand it is the parent’s responsibility to provide curriculum, do lesson planning, maintain a record of daily work, evaluate our student’s progress and that all decisions relating to educational philosophy and methods, style, selection of books, teaching material and curriculum, grading and evaluations are our responsibility. Therefore, the outcome of your student’s education rests on your efforts and that of your students.
	One parent will be at home during school hours and teaching our student in an orderly and systematic manner, at least 180 days of the year.
	We will enter attendance and grades at the times specified on the school calendar, realizing that timely attendance reporting is absolutely essential in an independent study program.
	We will post our elementary student’s proposed course of study and/or high school student’s course description on their report card page at the beginning of the school year.
	We understand that the School Calendar, NCCS Handbook, and the NCCS High School Manual have important dates and information that we need to know in order to work responsibly with NCCS. We agree to read through the Handbook/Manual and review the school calendar and acquainted ourselves with the school services and our responsibilities.
	We will notify NCCS if and when we enroll our student in another school as a matter of courtesy.
	We realize that our student will be dismissed from enrollment if: We fail to do our record keeping in accordance with the NCCS Handbook. We fail to comply with Parental Responsibility Agreement in any way.
	Although we believe it is the parent’s responsibility to direct their student’s education we have policies that may conflict with some family’s strategy. We feel these policies help support the integrity of North County Christian School. We will attempt to accommodate each parent’s philosophy and goals as much as possible.
Signature
	We have read through the Parental Responsibility Agreement, understand the requirements that pertain to us and our student, and agree to comply with them while we have our student enrolled in NCCS.

* Father�s signature:		Date:
* Mother�s signature:		Date:
Typing in your name and date is acknowledging your agreement and compliance with the Parental Responsibility Agreement. If this is not complete enrollment will not be processed.

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