NACS
NORTH ALABAMA CHRISTIAN SCHOOL
5651 AL HWY 40, VALLEY HEAD, AL 35989
ADMINISTRATOR: SANDRA SUMMERFORD
PHONE: 256-657-3380 FAX: 256-657-3308
E-MAIL:
northalabamachristianschool@yahoo.com
WEB ADDRESS :
www.northalabamachristianschool.net
Church School Enrollment Form
Last School Attended_______________________ Public School District
________
Grade Last School Year _______________Grade This School Year______________
I. To Be Completed By Parent/Guardian
Student’s Name_________________________________________________Phone_______________________
Last
First
Middle
Home Address ______________________________________________________________________
Mailing Address (only if different from home)
____________________________________________________________________
E-mail Address ______________________________________________________________________
Date of Birth _______________________________________SSN______________________________
If you are using the Penn-Foster Curriculum I need your Login________________
and Password_________________________________ unless you will be mailing grades to me.
Parent/Guardian Name_____________________________________Phone_______________________
Address (if different from student)
_________________________________________________________
______________
X __________________________________________
Date Signature
of Parent/Guardian
II. To Be Completed By Church School Administrator
This Form Certifies That This Student Is Enrolled In The Church School Listed Above.
___________________
___________________________
Date of Enrollment
Grade Level For Current School Year
_____________ ____________________________________
Date
Signature of Church School Administrator
III. To Be Completed By Parent/Guardian
Consent For Notification Of Student Withdrawal
*
The parent, guardian, or other person in charge
or control of the child shall by prior consent at the time of enrollment direct the church to notify the public school superintendent
or his agent that the said child no longer is in attendance at a church school, AL Code Section 16-28-7(1975).
_______________
X________________________________________
Date Signature
of Parent/Guardian
*
Enrollment WILL NOT be accepted unless
this section is signed and enrollment fee is paid in full at time of enrollment. Please send check or money order payable
to: Sandra Summerford along with this form to
the address listed above. Enrollment fees are as follows: $125.00 per family. Seniors will need to add an extra $75.00 which
will cover cap, gown, tassel, diploma, diploma cover, transcript and printing of programs for graduation.
