Skip to: site menu | section menu | main content

 

Online Student Application

Family Name*
Your Email Address*

 

Student Information

Last Name*
First Name*
Middle Name
Goes By*
Grade Entering*
Social Security Number
Date of Birth*
     
Sex*
Ethnic Heritage (for state reporting purposes)*
Applicant lives with*
Does the applicant have any medical conditions or physical disabilities the school should be aware of?*
   
If yes, explain.
Has the applicant ever been diagnosed with ADD or ADHD?*
   
Has the applicant ever been enrolled in a special education program or received help for a learning disability?*
   
Has the applicant ever repeated a grade?*
   
If yes, which grades?
Has the applicant ever been suspended or expelled from school?*
   
If yes, why?
Does the applicant require any academic support outside the classroom?*
   
If yes, explain what would be needed.
School presently enrolled in or last attended*
School district in which you reside
Do you desire pubic school transportation if your child is accepted? (K-12 only)*
   
If yes, please check the appropriate boxes
     
(Schools providing bus transportation are: Central Dauphin, Cumberland Valley, East Pennsboro, Harrisburg, Northern York, South Middleton, Steelton-Highspire, Susquehanna, Susquenita, West Shore.)

Family Information (Information from here to the end of application to be filled out for oldest student only.)

Father or Male Guardian

Father's Title
Father's Name
Father's Address
Father's email
Father's Phone Number
Father's Work Phone
Father's Cell phone
Father's Occupation
Father Self-Employed?
   
Father's Church

 

Mother or Female Guardian

Mother's Title
Mother's Name
Mother's Address
Mother's email
Mother's Phone Number
Mother's Work Phone
Mother's Cell phone
Mother's Occupation
Mother Self-Employed?
   
Mother's Church
If divorced, please indicate the type of custody ordered by the court.
   
Which spouse holds legal responsibility for school decisions?
Name
Relationship
Home Phone
Address

 

Billing

Please check the tuition payment method you prefer if accepted:*
   
   

 

Parental Agreement

In making application, we acknowledge that:
 

  1. We have acquainted ourselves fully with the program and policies of the school.
  2. We will cooperate fully with the administrative, educational, and financial policies of the school.
  3. We agree that our child will be held subject to the rules and regulations of Christian discipline as practiced by this school.
  4. We request the loan of textbooks and instructional materials in accordance with Pennsylvania Act 195 and Act 90 for our child.
    Please note that all materials are approved by the Bible Baptist School prior to their use.
  5. We hereby give permission for any photographs or publicity involving our child while a student at BBS to be used in connection with publicity of BBS.
  6. We grant permission for our child's name, address, and phone number to be included in a parent directory that will be given to class members.

 Signatures: Typing your name in the spaces below constitues your electronic signature.

Father's Signature
Mother's Signature
It is the policy of Bible Baptist School not to discriminate on the basis of an applicant’s race, color, sex (gender), or national or ethnic origin.

Parent Affirmation of Faith
Father/Male Guardian: How and when did you receive Christ as your personal Savior?
Mother/Female Guardian: How and when did you receive Christ as your personal Savior?