>Home >Enrollment >Application for Admissions Share Email Print Facebook Twitter Application for Admissions Name Address Afghanistan Albania Algeria Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Terr. Bonaire (Dutch Caribbean) Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo, Democratic Republic of Cook Islands Costa Rica Cote D'ivoire Croatia Cuba Curaçao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Terr. Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Heard Isl. & Mcdonald Isl. Vatican City State Honduras Hong Kong Hungary Iceland India Indonesia Iran, Islamic Republic of Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea, D P R Korea, Republic of Kuwait Kyrgyzstan Lao People's D R Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macao Macedonia, Former Y R of Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated States of Moldova, Republic of Monaco Mongolia Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Palestinian Territory, O Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Helena Saint Kitts and Nevis Saint Lucia Saint Pierre and Miquelon Saint Vincent & Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia and Montenegro Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia & S S Islands Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syrian Arab Republic Taiwan Tajikistan Tanzania, United Republic of Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States M O Islands Uruguay Uzbekistan Vanuatu Venezuela Vietnam Virgin Islands, British Virgin Islands, U.S. Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Phone Date of Birth Age Gender Male Female Race/Ethnicity American Indian or Alaska Native Arab/Middle Eastern Black/African origin East Asian/Southeast Asian Hispanic or Latino South Asian Native Hawaiian or Other Pacific Islander White/Caucasian Other Citizenship SDA Baptized Select an answer Yes No Baptism Date Grade Applying for Select the grade Pre-K Kindergarten Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 Grade 7 Grade 8 Grade 9 Grade 10 Grade 11 Grade 12 Previous School Attended (If not applicable, write "N/A") School Address Afghanistan Albania Algeria Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Terr. Bonaire (Dutch Caribbean) Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo, Democratic Republic of Cook Islands Costa Rica Cote D'ivoire Croatia Cuba Curaçao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Terr. Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Heard Isl. & Mcdonald Isl. Vatican City State Honduras Hong Kong Hungary Iceland India Indonesia Iran, Islamic Republic of Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea, D P R Korea, Republic of Kuwait Kyrgyzstan Lao People's D R Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macao Macedonia, Former Y R of Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated States of Moldova, Republic of Monaco Mongolia Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Palestinian Territory, O Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Helena Saint Kitts and Nevis Saint Lucia Saint Pierre and Miquelon Saint Vincent & Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia and Montenegro Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia & S S Islands Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syrian Arab Republic Taiwan Tajikistan Tanzania, United Republic of Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States M O Islands Uruguay Uzbekistan Vanuatu Venezuela Vietnam Virgin Islands, British Virgin Islands, U.S. Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe School Phone Number Father/Guardian Name Father/Guardian Email Father/Guardian Phone Number Father/Guardian Employer Father/Employer Occupation Father/Guardian Work Phone Number Father/Guardian Church Affiliation Mother/Guardian Name Mother/Guardian Email Mother/Guardian Number Mother/Guardian Employer Mother/Guardian Occupation Mother/Guardian Work Phone Number Mother/Guardian Church Affiliation Marital Status of Parents Select Marital Status Married Separated Widowed Single Parent Divorced Guardian/Custody Select Custody Mother & Father Father Only Mother Only Other If you replied "other" please write a response here Are there any legal issues the school should be aware of: Please select a response Yes No If yes, please explain: General Health of Applicant: Student Health Information Parents: If your child is rushed to the ER room for medical treatment, the ER physician will be asking the school some of the following questions concerning your child’s health. Please take a few moments to complete the questions below. Is your child subject to conditions that may cause epilepsy, diabetes, or fainting? Select a response Yes No If yes, please explain: Does your child have hearing or visual problems that requires sitting closer to the front of the classroom? Select a response Yes No If Yes, please explain: Does your child have respiratory problems such as asthma or bronchitis? Select a response Yes No If Yes, will an inhaler be sent to school with written directions for administering? Select a response Yes No Does your child have an allergy to any food or medication? If yes, please provide a statement from your child’s physician stating the allergy and other concerns. Select a response Yes No Does your child have frequent nosebleeds or frequent bathroom needs? If yes, please bring a statement from your child’s physician stating concerns. Select a response Yes No Does your child have other health conditions that prohibit participation in strenuous activities such as gym? If yes, please bring a statement from your child’s physician stating concerns. Select a response Yes No Has your child ever been diagnosed for attention disorders? If yes, please bring a statement from your child’s doctor or a copy of related tests for this disorder. Select a response Yes No Has your child been immunized for Chicken Pox? Select a response Yes No DPT/Td Vaccine completed? Select a response Yes No Name of your child’s physician? Physician's Phone Number Emergency Hospital Information Students will be taken to Garden City Hospital located on Inkster Rd. For ER care. A staff or faculty member will accompany and remain with the student until a parent/guardian arrives. Emergency Contact/Authorized Pick-Up Persons The school has permission to contact the following adults for medical emergencies such as ER treatment, field trip permission or to pick up my child(ren) during or after school when I cannot be contacted. Emergency Contact #1 - Full Name Emergency Contact #1 - Phone Number Emergency Contact #1 - Relationship Emergency Contact #2 - Full Name Emergency Contact #2 - Phone Number Emergency Contact #2 - Relationship Emergency Contact #3 - Full Name Emergency Contact #3 - Phone Number Emergency Contact #3 - Relationship Emergency Contact #4 - Full Name Emergency Contact #4 - Phone Number Emergency Contact #4 - Relationship Emergency Contact #5 - Full Name Emergency Contact #5 - Phone Emergency Contact #5 - Relationship Signature By signing below, that as the parent/guardian of my child, this application is accurate to the best of my ability. The name listed for emergency contact is the only individuals to whom my child will be released. If I need to add additional name to the list, I will communicate with the school to add additional names to the list. Please remember to submit a copy of immunization records, diagnostic report if applicable, and previous school records if applicable. Parent/Guardian Signature Date Submit
