NORTH IOWA CHRISTIAN SCHOOL

Student Full Name Birth Date Gender Email Phone Cell Phone Address City State Zip Current School Current Grade Medical Issues Medical Needs Medication Allergies Food Allergies Other Allergies Resident District

Parent/Guardian Information

Parent/Guardian #1 - Name Parent/Guardian #1 - Phone Parent/Guardian #1 - Occupation/Title/Place of Work Parent/Guardian #1 - Email Parent/Guardian #2 - Name (if applicable) Parent/Guardian #2 - Phone Parent/Guardian #2 - Occupation/Title/Place of Work Parent/Guardian #2 - Email Student Resides Primarily With If "Other", Please Comment

Emergency Contact Information

Emergency Contact Person (If parent is unreachable) Contact's Relationship to Student Contact's Phone Number The following people have permission to pick up my student(s) from school If you are a returning NICS student/family, please select this box and proceed to Section 2

Returning Student/Family

Section 1

Spiritual Life

North Iowa Christian School is an extension of your Christian home. Your home, your church and this school work as a team seeking to glorify Jesus Christ in all things. Based on this belief, we require at least one parent to be a professing Christian. Based on your relationship with Jesus Christ your Lord and Savior, Please answer the following questions.

Please explain your personal relationship with Jesus Christ The Christian home is critical to the home-church-school environment. How do you strive to be a Christian home? Please describe your family's commitment to Christ and His church. Which church do you attend? Pastor's Name Pastor's Phone and/or Email Please explain why you desire a Christian education for your child(ren).

Spiritual Reference

Please list two people for verification of your spiritual walk (i.e. ministry leader, personal Christian friend or advisor).

Reference #1 Name, Phone Number, and Email Address Reference #2 Name, Phone Number, and Email Address

Parental Expectations

North Iowa Christian School does not discriminate on the basis of race, color, nationality, gender and ethnic origin in administration of its educational policies, admission policies, scholarship programs and athletic and other school-administered programs. However, NICS is not obligated to admit every student. No student is guaranteed admission or re-enrollment under any circumstances.

NICS does reserve the right to select students on the basis of academic performance, compatible religious commitments and personal qualifications including willingness to cooperate with the NICS administration and abide by its policies.

1. I am in agreement with the rules and regulations set forth by the school and shall endeavor to support and uphold the principles, practices, and educational policies of North Iowa Christian School.

2. I understand that the school reserves the right to suspend or dismiss any student when justifiable grounds exist. (Only after much prayer and parental involvement.)

3. I agree that if my child experiences difficulties in school, I will first consult with the teacher or school coordinator and will in no case demonstrate a complaining spirit with other parents.

4. I understand the importance of meaningful parent-teacher cooperation and will make a concerted effort to attend scheduled meetings during the year.

5. I understand that my child will be disciplined according to scriptural principals.

6. I commit to fully paying all tuition and fees in a timely manner.

7. I agree that the school cannot provide a complete education for my child by natural means alone and pledge to support my child, the teachers, staff and administration in prayer.

8. As parents, we agree to accept the guidelines, mission, and aspirations of our school.

We hereby invest authority in the school for instruction, guidance, and caring for our child(ren). I agree with the above Statement of Faith and policies. I commit to joining the Christian community at NICS and will work in partnership with the school and my church in training my child(ren) in the way of our Lord and Savior, Jesus Christ.

Please check the box if you agree with the previous statements

I agree

Student Expectations

Attendance at NICS is a privilege that comes with certain responsibilities. Some of those responsibilities are outlined below. To be accepted at NICS, each student should carefully review the list below and then sign the agreement. Parents please review these with your student(s).

1. I will submit myself to my parent’s authority.

2. I will submit myself to those in authority at NICS and/or any rules that may be adopted or changed from time to time.

3. I will obey my teachers and treat them with respect.

4. I will be kind toward and respect my fellow students.

5. I will work to fulfill my classroom requirements.

6. I have read the parent/student handbook and will endeavor to stay in harmony with school standards and policies.

7. When areas of conflict arise, I will bring any questions or criticism directly to the teachers or administration so that the concerns may be dealt with properly by those in authority.

8. I have read the dress code as stated in the parent/student handbook and will endeavor to follow the spirit and letter of the code.

9. As a student I have a desire to attend NICS.

10. I agree to abstain from any sexual activity, drinking alcohol, smoking or using illegal drugs or being where this activity is taking place. I also agree to not use profanity or perverse language.

(For the Student) Please select this box if you agree to the above statements.

I agree

Developmental and School Experience

List the previous school experience of your child, including preschool. Has the student ever been retained at a grade level? If yes, which grade and why? Does the student have any special needs for which he/she will need special services now or later in his education? If so, please explain? Does the student have special characteristics or learning needs which you believe the teacher should know about?

Internet Use Policy

The purpose of teaching the use of technology is to give students essential life skills, to prepare them to use technology ethically and responsibly as Kingdom leaders in society, and to teach them the impact technology has on our culture and society.

1. The Internet is a powerful educational tool, providing world-wide access to museums, libraries, news, events, and many other resources. North Iowa Christian School expects its faculty to blend thoughtful use of the Internet throughout the curriculum and to provide guidance and instruction to students in its use. All users are expected to use Internet access to further educational and personal goals consistent with the mission of the school.

2. As with all media information sources, we need to exercise discernment in the use of the Internet.

3. Use of the school computers and the Internet is a privilege, not a right. Unacceptable use will result in losing that privilege.

4. Proper use of the Internet is the joint responsibility of students, parents and staff. Before students may gain access to the Internet, they must secure permission from a staff member who is willing to supervise them.

5. After reading this Internet Policy Guideline, the attached Contract for Internet Use must be signed by the student and the parent/guardian and returned to school. After this agreement is submitted to the classroom teacher, your child will be granted access to the Internet for academic purposes.

Student Agreement for Internet Use I have read and understand the Computer Use and Internet Policy Guidelines for North Iowa Christian School. I understand that the use of computers and the Internet is a privilege, not a right, and that unacceptable use will result in forfeiture of that privilege. I agree to abide by this policy for Computer and Internet use.

Student: Please select this box if you agree to the above statements.

I agree

Parent/Guardian Agreement I have read the Computer Use and Internet Policy Guidelines of North Iowa Christian School. I understand access is for educational purposes and precautions have been taken to block offensive material as much as possible. I also understand that should they use the privileges unacceptably, they will forfeit these privileges. I give permission for my children to use the Internet at North Iowa Christian School.

Parent: Please select this box if you agree to the above statements.

I agree

Section 2: For New and Returning Students/Families

Medical Information and Authorization

The following must be submitted via upload or paper copy to the school office prior to enrollment at North Iowa Christian School.

All New Students: Updated Immunization Record and Copy of Official Birth Certificate

Kindergarten: Dental Screening, Lead Screening, Physical (in addition to requirements for new students)

7th Grade: Physical

9th Grade: Dental Screening Sports: Physical (recommended not required)

Mason City area hospitals require a parent’s signature to give emergency treatment to minors not accompanied by a parent. In case of emergency, we are asking parents to complete the consent form and return it to North Iowa Christian School as soon as possible.

Please select the following box if you need a medical consent form.

I agree

Every effort will be made to notify parents or others shown on the emergency form. However, this emergency medical authorization will allow treatment or care to the student listed until such time as the parent/guardian or named emergency contact can be reached. It is the sole responsibility of the parent/guardian to notify the school of any change in the name of the physician to contact.

In case of emergency, it would be necessary to have the following information:

Physician Name Physician Phone

Health History

Has your student had a serious illness, operation or accident during the past year? If yes, please explain Please list any medical conditions your student has: Is your student under medical care for any health care problems? If yes, please explain Please list any allergies your student may have If your student has allergic reactions, will an epi-pen be at school? Does your student take medication regularly? If yes, please list name, dose, frequency and reason for use: If your student has asthma, will an inhaler be at school? If yes, please list any known factors that provoke your student’s asthma: Does your student have any activity restrictions? If yes, explain Does your student have any social/emotional difficulties or concerns that may affect your student's education? Is your student seeing a counselor? If yes, why? Has your student had any additional immunizations during the past year?

If yes, please submit an updated immunization record.

Does your student have a situation that could interfere with learning at school?

All medication must be given to the school office to be dispensed. Please do not send medication to school unless absolutely necessary. If it is necessary for your child to take medication during school, please contact the office for a permission form.

Permissions

Media Release

I give my consent to let my child(ren) be photographed and/or interviewed for use by NICS in newspapers, internet or other media for the purpose of publicity or advertising.

Please select your preference regarding media:

Student Drivers: Riding and Driving

Generally, non-driving students will ride with assigned adult drivers, but if necessary please indicate if it is permissible for your student to ride with a licensed student to-and-from school, PE off-campus, other local school activities and between school buildings. This would not be for any out-of-town activities.

• If you are the parent of a licensed student driver, please indicate whether or not your child has permission to transport other students to local school activities.

• This does not pertain to any parents transporting students to and from school for other parents or to a student driver transporting siblings.

• Both sets of parents must have permission.

• Any violation of Iowa driving laws or careless driving reported by an adult will result in the revocations of these driving privileges.

My student can RIDE to and from home and North Iowa Christian School with a licensed student driver. My student can RIDE as a passenger with a licensed student driver to local school activities off-campus. My student can DRIVE other NICS students to and from home and North Iowa Christian School. My student can DRIVE other NICS students to and from local school activities off-campus. Comments:

Travel Restraints

Please indicate what form of child-restraint your child requires for field trips/traveling (if any)

Open Campus

This information pertains to seniors only. If your student is not a senior, please select "N/A"

Open Campus is a privilege offered to North Iowa Christian School seniors. Open Campus means that a student may leave campus when their scheduled classes are completed for the day. Parents are given the option to determine their child’s participation. The policy was established for two reasons: first, due to efficient scheduling, most seniors have already completed the majority of graduation requirements; and second, due to NICS’s goal of academic excellence and life preparation, students have the opportunity through Open Campus to develop occupational skills or further their education through courses offered at nearby colleges or through the internet. The school does not mandate how Open Campus time is used and is not responsible for students once they have left school property. Students must sign out when they leave in order to give staff an indication of their whereabouts should an emergency arise. Students who remain on NICS campus will be required to be in study hall. Should school or classroom activities require attendance from a student who would regularly be on Open Campus, the student will be in attendance (i.e. field trips). Open Campus is a privilege which may be revoked by NICS board or administration should students actions warrant such change. NOTE: A student who does not have this form on file on NICS will not be given Open Campus privileges.

I have read and understand the responsibilities of the school during Open Campus hours and the expectations of my child during his/her attendance at school should he/she not participate in Open Campus.

Parent Committees

As part of the NICS family, at least one parent for each family is required to participate in one of the following committees to support the school by various endeavors.

Please select which committee you are interested in learning more about or participating in. A member of the selected committee will contact you with information after enrollment.

Tuition and Financial Aid

Click the link to view our Tuition/Fees.

TUITION/FEES Page

To learn about opportunities available to lower your cost of tuition, please select this box and a member of the finance committee will contact you.

Learn more about tuition and financial aid

Thank You!

You have reached the end of the application for enrollment at North Iowa Christian School! Thank you for the time and effort you have invested into your student and our school already!

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