ECS Church School Enrollment Form

School Year (e.g., 2004-05) *

Public School District *

Part 1 - to be completed by Parent or Guardian (one for each student)

Student First Name *

Student Middle Name *

Student Last Name *

Date of Birth * +

Grade *

Parent/Guardian Name *

City *

Street Address *

State *

Zip Code *

Parent/Legal Guardian Phone # *

Parent Signature *

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Date of Student Enrollment * +

Part 2 - Consent for Notification of Student Withdrawal (to be completed by Parent or Guardian)

Part 2 - PARENT/GUARDIAN CONSENT FOR NOTIFICATION OF STUDENT WITHDRAWAL. I hereby give prior consent to the Administrator of Evangel Christian School to notify the public school Superintendent should the student named above cease student attendance at Evangel Christian School. *

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Date * +

EVANGEL CHRISTIAN SCHOOL

William Snuggs, Administrator

Sandra Snuggs, Registrar

P.O. Box 1670

Alabaster, AL 35007

205.706.2595