CHILD INFORMATION

Number of children inquiring for:required

CHILD 1

Child First Namerequired

Child Last Namerequired

Gender

Date of Birthrequired (mm/dd/yyyy)

Select the grade your child is currently enrolled in, or the highest completed grade.required

Select all schools you would like to learn more about.*

Olivia Haverkamp Early Learning Center (18 mos - 3 yrs) Iroquois Campus, Grand Rapids Christian Elementary School (preschool - grade 4) Evergreen Campus, Grand Rapids Christian Elementary School (preschool - grade 5) Rockford Christian School (preschool - grade 8) Grand Rapids Christian Middle School (grade 5 - 8) Grand Rapids Christian High School (grade 9 - 12) International Student Program

When are you interested in starting this child in childcare?*

As soon as possible; as of today, my child is 18 months or older When my child is 18 months old Other

Requested Start Daterequired (mm/dd/yyyy)

Would you like to schedule a tour of the ELC?*

Yes Not at this time

Current Schoolrequired

For what school year/semester are you considering enrolling your child?required

In what grade are you interested in enrolling your child?required

Are you interested in Spanish Immersion?

Yes

Indicate any interests, hobbies, or special areas of consideration for your child.

Does your child have any special academic, social, or physical needs?*

Yes No

Please explain:required

CHILD 2

Child First Namerequired

Child Last Namerequired

Gender

Date of Birthrequired (mm/dd/yyyy)

Select the grade level your child is currently enrolled in, or the highest completed grade level.required

Select all schools you would like to learn more about.*

Olivia Haverkamp Early Learning Center (18 mos - 3 yrs) Iroquois Campus, Grand Rapids Christian Elementary School (preschool - grade 4) Evergreen Campus, Grand Rapids Christian Elementary School (preschool - grade 5) Rockford Christian School (preschool - grade 8) Grand Rapids Christian Middle School (grade 5 - 8) Grand Rapids Christian High School (grade 9 - 12) International Student Program

When are you interested in starting this child in childcare?*

As soon as possible; as of today, my child is 18 months or older When my child is 18 months old Other

Requested Start Daterequired (mm/dd/yyyy)

Would you like to schedule a tour of the ELC?*

Yes Not at this time

Tour Date Preference*

Friday, July 24, 10:00 - 11:00 am I will contact the ELC to schedule a tour.

Current Schoolrequired

For what school year/semester are you considering enrolling your child?required

In what grade are you interested in enrolling your child?required

Are you interested in Spanish Immersion?

Yes

Indicate any interests, hobbies, or special areas of consideration for your child.

Does your child have any special academic, social, or physical needs?*

Yes No

Please explain:required

CHILD 3

Child First Namerequired

Child Last Namerequired

Gender

Date of Birthrequired (mm/dd/yyyy)

Current Select the grade level your child is currently enrolled in, or the highest completed grade level.required

Select all schools you would like to learn more about.*

Olivia Haverkamp Early Learning Center (18 mos - 3 yrs) Iroquois Campus, Grand Rapids Christian Elementary School (preschool - grade 4) Evergreen Campus, Grand Rapids Christian Elementary School (preschool - grade 5) Rockford Christian School (preschool - grade 8) Grand Rapids Christian Middle School (grade 5 - 8) Grand Rapids Christian High School (grade 9 - 12) International Student Program

When are you interested in starting this child in childcare?*

As soon as possible; as of today, my child is 18 months or older When my child is 18 months old Other

Requested Start Daterequired (mm/dd/yyyy)

Would you like to schedule a tour of the ELC?*

Yes Not at this time

Tour Date Preference*

Friday, July 24, 10:00 - 11:00 am I will contact the ELC to schedule a tour.

Current Schoolrequired

For what school year/semester are you considering enrolling your child?required

In what grade are you interested in enrolling your child?required

Are you interested in Spanish Immersion?

Yes

Indicate any interests, hobbies, or special areas of consideration for your child.

Does your child have any special academic, social, or physical needs?*

Yes No

Please explain:required

CHILD 4

Child First Namerequired

ChildLast Namerequired

Gender

Date of Birthrequired (mm/dd/yyyy)

Select the grade level your child is currently enrolled in, or the highest completed grade level.required

Select all schools you would like to learn more about.*

Olivia Haverkamp Early Learning Center (18 mos - 3 yrs) Iroquois Campus, Grand Rapids Christian Elementary School (preschool - grade 4) Evergreen Campus, Grand Rapids Christian Elementary School (preschool - grade 5) Rockford Christian School (preschool - grade 8) Grand Rapids Christian Middle School (grade 5 - 8) Grand Rapids Christian High School (grade 9 - 12) International Student Program

When are you interested in starting this child in childcare?*

As soon as possible; as of today, my child is 18 months or older When my child is 18 months old Other

Requested Start Daterequired (mm/dd/yyyy)

Would you like to schedule a tour of the ELC?*

Yes Not at this time

Tour Date Preference*

Friday, July 24, 10:00 - 11:00 am I will contact the ELC to schedule a tour.

Current Schoolrequired

For what school year/semester are you considering enrolling your child?required

In what grade are you interested in enrolling your child?required

Are you interested in Spanish Immersion?

Yes

Indicate any interests, hobbies, or special areas of consideration for your child.

Does your child have any special academic, social, or physical needs?*

Yes No

Please explain:required

CHILD 5

Child First Namerequired

Child Last Namerequired

Gender

Date of Birthrequired (mm/dd/yyyy)

Select the grade level your child is currently enrolled in, or the highest completed grade level.required

Select all schools you would like to learn more about.*

Olivia Haverkamp Early Learning Center (18 mos - 3 yrs) Iroquois Campus, Grand Rapids Christian Elementary School (preschool - grade 4) Evergreen Campus, Grand Rapids Christian Elementary School (preschool - grade 5) Rockford Christian School (preschool - grade 8) Grand Rapids Christian Middle School (grade 5 - 8) Grand Rapids Christian High School (grade 9 - 12) International Student Program

When are you interested in starting this child in childcare?*

As soon as possible; as of today, my child is 18 months or older When my child is 18 months old Other

Requested Start Daterequired (mm/dd/yyyy)

Would you like to schedule a tour of the ELC?*

Yes Not at this time

Tour Date Preference*

Friday, July 24, 10:00 - 11:00 am I will contact the ELC to schedule a tour.

Current Schoolrequired

For what school year/semester are you considering enrolling your child?required

In what grade are you interested in enrolling your child?required

Are you interested in Spanish Immersion?

Yes

Indicate any interests, hobbies, or special areas of consideration for your child.

Does your child have any special academic, social, or physical needs?*

Yes No

Please explain:required

HOME INFORMATION

Addressrequired

Cityrequired

Staterequired

Zip Coderequired

PARENT/GUARDIAN INFORMATION

Parent(s)/Guardian(s) First and Last Namerequired

Emailrequired

Phone (xxx-xxx-xxxx)

Would you like to schedule a tour at a campus other than the ELC?*

Yes No

Questions or additional information:

Are you interested in, or have you already applied for Variable Tuition? (available for students in kindergarten - 12th grade)*

Yes, interested in applying Yes, already applied No