Admission Formadmin2023-07-12T19:44:06+00:00 Living Waters Christian Preparatory School 2822 Cashwell Street Goldsboro, NC 27534 A $75.00 application fee must accompany this application ApplicationApplication For(Required) Fall Spring School Year(Required) Applying For Grade K-9(Required) Applicant Status(Required) New Applicant Have Applied Before Returning Student Name(Required) First Middle Last Preferred Name(Required) Preferred Name Address(Required) Street Address Apartment City State / Province / Region ZIP Phone(Required)Date Of Birth(Required) Month Day Year Gender(Required) Male Female Third Choice Ethnic background (OPTIONAL for demographic reporting purposes): African American Hispanic Caucasian Asian Indian Other Applicant lives with (check all that apply)(Required) Mother Father Legal Guardian Applicant’s Parent (s)(Required) Married Separated Divorced Deceased If divorced, which spouse holds legal responsibility for school decisions? (Please submit copies of all court documents regarding custody and educational decisions along with the application.) Drop files here or Select files Accepted file types: jpg, png, pdf, Max. file size: 10 MB, Max. files: 5. Father's InformationName Prefix/Title Relationship to Applicant Father Stepfather Legal Guardian Parent / Guardian First Name Middle Name Last Name Preferred Name Preferred Name Home Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Home PhoneCell PhoneWork PhonePlace of Employment Position Business Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Mother's InformationName Prefix/Title Relationship to Applicant Mother Step mother Legal Guardian Parent / Guardian First Name Middle Name Last Name Preferred Name Preferred Name Home Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Home PhoneCell PhoneWork PhonePosition Place Of Employment Business Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Other children in the familyNameDate Of BirthGradeSchool Add Remove(Attach separate sheet, if necessary)Accepted file types: jpg, png, pdf, docx, Max. file size: 5 MB.We first learned of LWCPS through : Church Mail Internet Other Athletics/Activities applicant has participated in or is interest in Factors that influenced us to apply to LWCPS Academic Reputation Christian Philosophy Desire to attend a private school Displeasure with local schools Location Is this applicant eligible to return to his/her current school? Yes No Has your child ever been suspended from any school or asked to leave? Yes No Please explain:I/We hereby authorize LWCPS to obtain all scholastic information/files from all previous schools Yes No Has the applicant received special help for reading or learning difficulty? Yes No Has the applicant been diagnosed with ADD or ADHD? Yes No Is the applicant presently taking any medication? Yes No If yes, what medications ? Describe any illness, diseases, or physical disabilities that either have affected or may affect your child’s general health, schoolwork, or participation in the school’s activities. Are there currently any behavioral, psychological, or educational evaluations treatments, or interventions?Please include your parental perspective on your child. Include your child’s strengths and abilities, special interests, areas of concern. We appreciate your assistance in helping us to know your child better.Grandparents’ Name(s) and Complete Address(es) including first and last names and zip code(s)Parent/Guardian Signature Reset signature Signature locked. Reset to sign again Date This application must be completed in its entirety by or on behalf of all students seeking admission to Living Waters Christian Preparatory School. It should be filed, along with a non-refundable application fee of $75.00.00 at the school office or mailed to: Attention: Admission Office Living Waters Christian Preparatory School 2822 Cashwell Drive Goldsboro, NC 27534
