ICA Application - Bethesda

Parent/Guardian Email Address

Last Grade Completed

Father's Name (If Not Applicable Type "N/A")

Father's Employment (If Not Applicable Type "N/A")

Position (If Not Applicable Type "N/A")

Father's Phone Number (If Not Applicable Type "N/A")

Mother's Name (If Not Applicable Type "N/A")

Mother's Employment (If Not Applicable Type "N/A")

Position (If Not Applicable Type "N/A")

Mother's Phone Number (If Not Applicable Type "N/A")

Emergency Phone Numbers (Other Than Those Listed)

Children In Family Of School Age (If Not Applying)

Reasons They Are Not Applying

Has Applicant Ever Made A Profession Of Faith In Christ?

Please State And Explain Any Allergies Or Physical Challenges

Has Student Received Immunizations?

How Did You Hear About ICA?

Reason For Selecting ICA

"I hereby pledge to pay my financial obligations to the school on the date and understand that it my be necessary to withdraw my student if proper arrangements are not made on a past due account"

"I give permission for my student to take part in all school activities, including sports and school-sponsored trips away from the school premises, and absolve from the school any liability to me or my student because of injury to my student at school or during school activity."

"I agree to uphold and support the high academic standards of the school by providing a place at home for my student to study and giving my student encouragement in the completion of any homework or assignments." "I appreciate the standards of the school and do not tolerate profanity, obscenity in word or action, dishonor to the Godhead and the Word of God, or disrespect tot eh personnel of the school"

"I agree to support all regulations of the school in the applicant's behalf authorize this school to employ discipling as it deems wise and expedient for the training of my student."

"I understand the school reserves the right to dismiss any student who fails to comply with the established regulations and discipline or whose financial obligation remains unpaid."

"I have read the student handbook and understand the terms stated on this Application and agree thereto."

Signature Of Parent/Guardian

Sunday Service:

ICA Student Application