Application - Lighthouse Christian Academy of Dawsonville, GA

1Statement of Cooperation

2Student Pledge

3Transcript Release

4Student Information

5Family History

6Agreement

Student Conduct Agreement 7th-12th Grades

This form must be completed by the student. There are no “right” or “wrong” answers, and it is essential that you answer honestly.
Student's Full Legal Name*
Do You Attend Church Regularly?
If So, Which Church?
Do you have any objections to saluting to the United States Flag, Christian flag, or the Bible?*
Do you understand and acknowledge that the standards of Lighthouse Christian Academy are based on principles found in the Scriptures?*
Will you establish and have a daily time for Bible reading and prayer?*
Will you agree to keep all school rules and respect authority without being critical and finding fault?*
Do you have a desire to grow academically, physically, spiritually, and socially?*
Do you want to attend Lighthouse Christian Academy?*
Please explain why or why not?
Please explain your salvation experience:
Student Pledge
*
- I realize that admission at Lighthouse Christian Academy is a privilege and not a right, and if at any time my conduct, standards, or spirit is not in keeping with the school’s policies, I may be dismissed.
*
- I understand the goals and purpose of Lighthouse Christian Academy and fully support them.
*
- I will attend weekly services of my church unless providentially hindered.
*
- I will maintain Christian standards in courtesy, kindness, morality, and honesty. I will strive to be of unquestionable character in dress, conduct and other areas of life.
*
- As a student of Lighthouse Christian Academy, I will not cheat, swear, bully, gossip, be tardy, smoke, vape, gamble, drink alcoholic beverages, damage school/church property, use indecent language, use drugs, or behave in a disorderly or disrespectful manner that would tarnish the name of the Lord, of my school, my teachers, or my church. I realize failure in any of these areas will result in my suspension or possible expulsion from LCA.
*
- I will strive with all I have to be a Christian witness, read my Bible, and pray every day.
While these standards will be strictly enforced, it needs to be understood that we are far more interested in the student’s spirit and attitude than outward conformity to the standards with a rebellious spirit. The student should know that attitude is equally important as actions.
Students's Signature*
Parent/Guardian Signature*
Date*
MM slash DD slash YYYY
Date*
MM slash DD slash YYYY

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Transcript Release
Today's Date*
MM slash DD slash YYYY
Student's Name*
First Last
Birth Date*
Month
Day
Year
Gender
Primary Residence Address*
Street Address City State ZIP Code
- Mailing address is different than primary residence
Mailing Address
Street Address City State ZIP Code
Home Phone*
School Name*
School Address*
Street Address City State ZIP Code
I give my permission for the release of 's school records , medical records, test scores, grades, and credits from .
Parent/Guardian Signature*
Date*
MM slash DD slash YYYY

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Student Information
Student's Name*
First Middle Last
Birth Date*
Month
Day
Year
Gender*
Student Mailing Address*
Street Address City State ZIP Code
Social Security Number*
Grade Entering in the Fall*
Previous School Name
Previous School City and State
City State
Reason for leaving previous school
Has your child ever been suspended or expelled from another school?
Please explain
Has your child ever been held back a grade?
Please explain
Does your child have any outstanding debts at a previous school?
Does your child have any behavioral/emotional problems that will affect their school work?
Please explain
Does your child have any documented conditions that may require attention? (food allergies, IEP, asthma, etc.)
Please explain
Has your child ever been in a gifted education program?
What are your child’s post-graduation goals/plans? (7th–12th graders only)
Student’s extracurricular interests and talents:
Has the student accepted Christ as their personal Savior?
Please share their salvation experience:

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Father's Name
Cell Phone
Address (if different from student)
Street Address City State ZIP Code
Please specify custody arrangements if child does not live with both parents:
Father's Occupation
Employer
Work Phone
Email
Mother's Name
Cell Phone
Address (if different from student)
Street Address City State ZIP Code
Mother's Occupation
Employer
Work Phone
Email
Does child have a legal guardian other than the parents?
Guardian Full Name
Guardian Cell Phone
Address (if different from student)
Street Address City State ZIP Code
Email
Emergency Contacts (must provide two)
Contact One Name*
Relationship*
Phone*
Contact Two Name*
Relationship*
Phone*
Siblings
Name
Age
School Attending
Name
Age
School Attending
Name
Age
School Attending
Name
Age
School Attending
Are you members of Lighthouse Baptist Church, Dawsonville?
Would you be interested in membership?
Current Church
Pastor
Address
Street Address City State ZIP Code
How often does your family attend church services?
Do the student(s’) parents testify to having a personal relationship with Jesus Christ?

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Lighthouse Christian Academy admits students of any race, color, national and ethnic origins to all rights, privileges, programs and activities made available to students at the school. Lighthouse Christian Academy does not discriminate on the basis of race, color, national and ethnic origin in administration of the educational policies, admission policies or academic, athletic, and other various school-administered programs.

By applying for admission to Lighthouse Christian Academy, the Parents’/Guardians’ understand that:
Processing fee of $200 per family is not refundable for any reason and must accompany the application. If applying before February 1st, the application fee is $100.
Lighthouse Christian Academy reserves the right to dismiss my child for not cooperating with the educational processes and procedures set forth, either in attitude or in action.
Tuition payments must be made no later than the 1st of each month and are subject to a late fee of $50 after the 10th of each month.
Attendance at orientation and conferences is crucial to the success of my child.
My child has permission to participate in all school activities, including school sponsored trips away from the school property, and absolve the school from any liability for ourselves and our child because of any accident or injury that occurs.
In the case of accident or injury, I understand Lighthouse Christian Academy will first try to contact me, second the emergency contacts, but if these efforts fail, I authorize the school to take the appropriate action necessary for the well-being and safety of my child.
Final acceptance in the grade level requested for my child is subject to review and evaluation of records submitted, followed by an interview with the administration.
We hereby agree to the aims and policies of the school.
Printed Name
Printed Name
Signature
Signature
Date
MM slash DD slash YYYY
Date
MM slash DD slash YYYY
A copy of the documents is required to complete an application. You may upload the document using the form fields below or turn them into the school office via email, mail, or in-person at a later date. You may submit this application now without the attached documents so that Lighthouse Christian Academy can begin processing your application.
Copy of Birth Certificate
Max. file size: 256 MB.
Immunization
Max. file size: 256 MB.
Completed Georgia Immunization Certificate 3231 or notarized affidavit of religious exemption
Report Card
Max. file size: 256 MB.
Copy of most recent report card
Homeschool Transcripts
Max. file size: 256 MB.
If student is currently home schooled
Name
This field is for validation purposes and should be left unchanged.

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No spam. No mailing lists. We just need your information to follow up with a call or email.

LCA Parent Statement of Cooperation

Student Conduct Agreement 7th-12th Grades

Student Pledge

Transcript Release

Student Information