CHILD INFORMATION

Number of children inquiring for:required

CHILD 1

Child First Namerequired

Child Last Namerequired

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

Gender

Date of Birthrequired (mm/dd/yyyy)

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)

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)

Current Schoolrequired

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

In what grade are you interested in enrolling your child?

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:

CHILD 2

Child First Namerequired

Child Last Namerequired

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

Gender

Date of Birthrequired (mm/dd/yyyy)

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)

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)

Current Schoolrequired

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

In what grade are you interested in enrolling your child?

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:

CHILD 3

Child First Namerequired

Child Last Namerequired

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

Gender

Date of Birthrequired (mm/dd/yyyy)

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)

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 Other

Requested Start Daterequired (mm/dd/yyyy)

Current Schoolrequired

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

In what grade are you interested in enrolling your child?

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:

CHILD 4

Child First Namerequired

ChildLast Namerequired

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

Gender

Date of Birthrequired (mm/dd/yyyy)

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)

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)

Current Schoolrequired

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

In what grade are you interested in enrolling your child?

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:

CHILD 5

Child First Namerequired

Child Last Namerequired

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

Gender

Date of Birthrequired (mm/dd/yyyy)

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)

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 Other

Requested Start Daterequired (mm/dd/yyyy)

Current Schoolrequired

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

In what grade are you interested in enrolling your child?

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:

HOME INFORMATION

Addressrequired

Cityrequired

Staterequired

Ziprequired

PARENT/GUARDIAN INFORMATION

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

Emailrequired

Phone (xxx-xxx-xxxx)

Would you like to schedule a tour?

Yes No

A member of the Admissions Team will connect with you to schedule a tour.

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

How did you hear about Grand Rapids Christian Schools? (Check all that apply.)