Online Application


    Your Name*

    Student Information

    Student Name*

    Address*

    School District*

    Gender* malefemale

    Age*

    Birthday*

    Home Phone

    Parent Cell Phone

    Student Cell Phone

    Parent Email*

    Student Email

    School Last Attended*

    School Address

    Last Grade Completed*

    Family Information

    Father's Name

    Legal Guardian? yesno

    Employer

    Position

    Business Phone

    Mother's Name

    Legal Guardian? yesno

    Employer

    Position

    Business Phone

    Marital Status*
    MarriedDivorcedWidowedSeparatedSingle

    Other children in the family (name and age):

    Medical Information

    Family Physician*

    Phone

    Allergies*

    Please have your doctor complete the Medical Exam Form and submit it with your application.

    Church Background

    Do you regularly attend Church?*
    Father yesno
    Mother yesno
    Student yesno

    If yes, what church do you regularly attend?

    Are you a member?*
    Father yesno
    Mother yesno
    Student yesno

    Has applicant ever made a profession of faith in Christ?* yesno

    If you attend a church besides Lighthouse Baptist Church, please have your pastor mail or email a recommendation letter directly to the school.

    Scholastic Information

    Has the student ever been expelled, dismissed, suspended, or refused admission to another school?* yesno
    If yes, explain:

    Has the student had chronic disciplinary difficulty at school?* yesno
    If yes, explain:

    Does the student have a juvenile or arrest record?* yesno
    If yes, explain:

    Has the student ever used tobacco or nonprescription drugs of any kind?* yesno
    If yes, explain:

    General Information

    How did you hear about this school?*

    Reason for selecting this school:*

    We must have the following before your application can be processed:
    1. This completed application
    2. An interview with the parents and the student
    3. Nonrefundable registration fee of $50
    After completion of these items, your application will be reviewed for final acceptance.

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