Wachusett Hills Christian School

Prospective Students

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FOR YOUR CONVENIENCE, you may complete our online registration form below, or if you prefer, you may download a printable form to be hand-submitted to the school.

GENERAL INFORMATION

Please check the information below and make any necessary changes. This information is needed for the school register and cumulative folders. Since these are legal documents, they need to be kept updated. Rest assured that all information submitted shall remain strictly confidential and will be shared with no one other than school officials with a need to know. Thank you for taking the time to make this form as complete as possible.

Pupils full name

Birth date

Birth place

Next grade child will be entering

Name of last school attended

Is the student baptized?

Yes No

If yes, date of baptism

Place baptized

Place of membership

Father's name

Mother's name

Student's home address

Student's mailing address if different from above

Phone number

PARENT INFORMATION

Father

Father's address if different from above

Father's phone

Father's work phone

Father's cell phone

Father's occupation

Father's church affiliation

Father's citizenship

Father's place of birth

Language spoken at home

Father's highest level of education completed

Elementary school High school Technical school Associates Degree Bachelors Degree Masters Degree PHD Degree

Mother

Mother's address if different from above

Mother's phone

Mother's work phone

Mother's cell phone

Mother's occupation

Mother's church affiliation

Mother's citizenship

Mother's place of birth

Language spoken at home

Mother's highest level of education completed

Elementary school High school Technical school Associates Degree Bachelors Degree Masters Degree PHD Degree

EMERGENCY CONTACT INFORMATION:

In case of emergency, we may call

Relationship

Home phone

Work phone

Family doctor

Family doctor's phone

Does your child have an IEP, Individual Education Plan?

Yes No

Email Address

Do you anticipate needing after school care?

Yes No

I GIVE MY PERMISSION FOR MY CHILD TO BE: (PLEASE CHECK ALL THAT APPLY).

Videotaped or have pictures taken for student evaluation

Yes No

Photographed for the year book

Yes No

Photographed for the school web site

Yes No

Included in the student directory with their name, parent's name, address and phone number

Yes No

THIS DIRECTORY IS GIVEN TO EACH FAMILY AT THE BEGINNING OF THE YEAR

If all the information is correct, please sign below. (Please be advised that this equates to your official electronic signature)

Signature

Date signed

FINANCIAL INFORMATION:

Parent/Guardian name(s)

Student's name (s)

Home address

Billing address if different from above

Phone

Cell phone

Email Address

Check all that apply

I am an Adventist
...Constituent of the Gardner SDA Church
...Constituent of the Fitchburg SDA Church
...Non-constituent Adventist
Non-Adventist

SNEC 3-way Plan

I am planning to apply for the Southern New England Conference 3-way Plan.
I am NOT planning to apply for the Southern New England Conference 3-way Plan.

Do you anticipate needing assistance from the WHCS Scholarship Fund?

Yes No

Please keep in mind that the availability of funds is limited and reserved for the most needy. Fulfillment of requests is subject to school board vote based on perceived need with Adventist affiliation taking first priority. Typically, our customary scholarship is $50/mth.

If yes, amount requested per month

Do you expect to receive any financial assistance from any other source.

Yes No

If yes, please provide source

I would like to request special consideration in paying my tuition based on the following plan of action

REMINDERS:

* All outstanding balances from previous years must be paid in full prior to registering for current year. * Tuition balances in excess of 1 month overdue will jeopardize your child's continued enrollment, unless other financial arrangements have been made with the treasurer. * A 5% discount applies for upfront payment of entire year. * First semester deadline for SNEC 3-way plan application to be received by conference is October 31st. * Second semester deadline for SNEC 3-way plan application to be received by conference is March 31st.