Hope Christian School

Pre-Qualification Form

Today's Date: Saturday, June 24th, 2017

Hope Christian School Information Sheet
Please read document above

Primary Teacher's First and Last Name:


Spouse's First and Last Name:


Primary Teacher's Relationship to Students:


Street Address:

City: State:

Zip Code:

Email:

Phone:

Mailing Address same as Home Address? Yes No


1. If an HCS family has referred you, please enter their information below.

2. How many children will you be enrolling?


3. Please provide each student's name & grade levels for the 2017/2018 school year.



4. What school did the student(s) attend for the previous school year?


5. What is the primary teacher's highest level of education?


6. If no college experience, did the Parent Teacher receive a high school diploma?
Yes No Not Applicable

7. Will the primary teacher work outside the home during school hours?
Yes No

8. Do you and your family attend church?
Yes No

9. Have any of the children to be enrolled ever been suspended, attended or requested to attend an alternative school, expelled, or forced or given the choice to withdraw rather than be expelled at anytime for any reason, or has the student been committed to an institution for behavior or substance abuse?
Yes No

10. Have any of the enrolling students been pregnant, are currently pregnant, if female or if male, fathered a child out of wedlock?
Yes No

11. Are there any children enrolling not the biological children of both parents?
Does not apply to Legal Adoptions
Yes No



Thank you for taking the time to complete this questionnaire. As soon as we receive it, we will be in contact with information regarding your application. If you have any questions or if there is anything we can help with, please feel free to call us at 205.664.2232 or email us at admin@hopechristian.net. We look forward to hearing from you!

Comments - Please add any comments or additional information you feel we might need to know. You may also add any questions you might have to this area.: