917 Carolina Road, Suffolk, VA 23434
Elementary (757) 925-4461 ▪ Secondary (757) 809-6606
Welcome!
Thank you for your interest in Suffolk Christian Academy. Our school has been in the ministry of
educating students for 28 years. You may explore the academic, athletic, social, and spiritual
activities available to your child at SCA by visiting our official school website at
www.suffolkchristianacademy.org.
Suffolk Christian Academy is committed to academic excellence and spiritual development. We
believe that spiritual development is essential in educating the whole-student, and this is what
distinguishes SCA from other educational institutions.
God is accomplishing amazing things in the lives of our students. We share some of these
accomplishments in our monthly Mind, Heart, Spirit Tour. You are invited to attend one of our
tours, which are held the 2nd Thursday of each month at 5:30 p.m.
We have exciting news! Our school will be moving onto one campus beginning this next school
year. All of our preschool through 12th grade classes will be held at our Southside location, 917
Carolina Road, Suffolk, VA 23434.
Please contact us for any questions you may have. We look forward to partnering with you in the
education of your child/children in the coming 2017-18 school year.
In His service,
Mrs. Tamra VanDorn
Headmaster
I have no greater joy than to hear that my children walk in truth.
~III John 1:4
New Student Application Checklist
1) Application for Admission: Complete the paperwork contained in the admissions packet. Once all of the following
items are completed and have been submitted to the Admissions office, the admission process will be initiated.
□ Application for Admissions form
□ Family Medical Consent & Emergency Information
□ Signed Illness Policy
□ Signed Statement of Faith, & Statement of Cooperation
□ Student Record Release Authorization:
□ Student Records: Copy of previous school(s) records including all educational, disciplinary, and
diagnostic testing, standardized tests from last two years, current report card and report card from
past two years or a transcript for grades 8-12 (Kindergarten applicants – N/A)
□ Copy of student’s birth certificate
□ Health Records: Immunization records must be submitted with the Application for Admissions form.
Rising 6th graders are required to have tetanus, diphtheria, pertussis (Tdap) prior to start of school.
□ Kindergarten students are required to have a physical using the Commonwealth of Virginia School
Entrance Health Form completed by a physician prior to the start of school.
(www.vdh.virginia.gov/epidemiology/immunization/requirements.htm)
□ Student Questionnaire: Kindergarten Readiness Checklist AND/OR 6th-12th Grade Student Questionnaire
□ Application Fee
□ In the case of a divorce, the parent must submit a notarized copy, signed by a judge, of the most
recent court document regarding custody and educational decisions.
Please send the following to your child’s church/school directly to the Admissions office
□ Pastoral Reference Form completed by the family’s pastor (Pastor will fax to SCA)
□ Confidential Teacher Evaluation of student completed by current teacher (Parent may provide to
Teacher, or SCA office will fax to current school for completion)
2) Testing: Upon receipt of the completed (a) Application for Admissions, (b) Application Fee, and (c) the Pastoral
Reference Form, the student will be scheduled for testing.
3) Family Interview: After reviewing the admissions forms and test results, an interview will be scheduled with the
family. The presence of both parents is required, if possible. Sixth –twelfth grade applicants must attend.
4) Notice of Acceptance: Admissions information, test results, the family interview, and all documents submitted to
SCA will be considered for determining acceptance or non-acceptance to SCA. A written notice of acceptance will
be mailed to the applicant’s family.
5) Financial Contract: Student enrollment is secured only after a financial contract has been signed by all responsible
parties. The first tuition payment is due July 1, 2017.
Suffolk Christian Academy does not discriminate on the basis of race, gender, color, national ethnic origin in administration of
its educational policies, admissions policies, financial policies, and athletic and other school programs.
(2017-2018)
1
Application for Admissions
2017-2018
I. Student Information
Student’s Name
Last
First
Gender
Middle
Grade
Entering
Birth Date/
Age
Extended
Care
Needed
(Yes/No)
Who may we thank for referring you to our school? ______________________________________
II. Parent/Guardian Information
Father/Guardian’s Full name: _______________________________________________________________
Street Address: ______________________________ City__________________ State_____ Zip __________
Occupation: __________________________________ Employer: __________________________________
Telephone: (H) ________________________ (W) ______________________(C) ______________________
Email address: __________________________________ Full access to records/communication: Yes
No
Mother/Guardian’s Full name: ______________________________________________________________
Street Address: ______________________________ City__________________ State_____ Zip __________
Occupation: __________________________________ Employer: __________________________________
Telephone: (H) __________________________ (W) ______________________(C) ____________________
Email address: __________________________________ Full access to records/communication: Yes
No
Custody: Student(s) live with _____both parents _____mother _____ father _____ guardian
If divorced, what are the legal custody provisions determined by the court? All necessary documentation
provided to SCA will be kept confidential. _____________________________________________________
Which spouse holds legal responsibility for school decisions? ______________________________________
Which spouse/s may receive correspondence? _________________________________________________
Suffolk Christian Academy does not discriminate on the basis of race, gender, color, national ethnic origin in administration of
its educational policies, admissions policies, financial policies, and athletic and other school programs.
III. Important Information SCA needs to know about your child/children: _____________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
IV. Emergency Contacts
Provide at least two (2) people to contact in an emergency if parents cannot be reached: Contacts
should be local and accessible.
Emergency Contact’s Full name: _____________________________________________________________
Street Address: ______________________________ City__________________ State_____ Zip __________
Occupation: __________________________________ Employer: __________________________________
Telephone: (H) __________________________ (W) ______________________(C)
_____________________
Emergency Contact’s Full name: _____________________________________________________________
Street Address: ______________________________ City__________________ State_____ Zip __________
Occupation: __________________________________ Employer: __________________________________
Telephone: (H) __________________________ (W) ______________________(C) ____________________
Please note: Parents will need to make arrangements for any student who develops symptoms
of an illness during the school day to be picked up within forty-five (45) minutes of contact by
the school office.
V. Pick-up Information
Persons Authorized for Pick-up:
1. ___________________________
2. ___________________________
3. ___________________________
Persons NOT Authorized for Pick-up:
1. ___________________________
2. ___________________________
3. ___________________________
4. ___________________________
5. ___________________________
6. ___________________________
4. ___________________________
5. ___________________________
6. ___________________________
VI. Spiritual Information
Are one or both parents/guardians a follower of Jesus Christ? ___________________________
What church do you attend? ________________________________ Are you a member? _____
Which accurately describes your church attendance?
____Active ____Often _____Occasional _____ Seldom_____ Never
(2017-2018)
3
How many years have you attended this church? ______________
Describe why you want your child/children to receive a Christian education: __________________
________________________________________________________________________________
________________________________________________________________________________
What expectations do you have for the education your child/children will receive at SCA? _______
________________________________________________________________________________
________________________________________________________________________________
Briefly explain you understanding of Jesus Christ: ________________________________________
________________________________________________________________________________
________________________________________________________________________________
How would you describe your relationship with Christ and the difference He makes in your life?
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
Describe the ways in which you integrate your faith into your family’s life: ____________________
________________________________________________________________________________
________________________________________________________________________________
VII. Educational Information
Please list all schools attended for each child, including kindergarten:
Student’s name: ___________________________
Name of School
Address
Years Attended
Student’s name: ___________________________
Name of School
Address
Years Attended
Student’s name: ___________________________
Name of School
Address
Years Attended
Student’s name: __________________________
Name of School
Address
Years Attended
VIII.
a)
Media Release & Other Policies
I give my permission for my child to be included in SCA publications including the yearbook, class picture,
publicity releases, and media coverage. □yes □no
b) I have read and agree to faithfully comply with the school’s illness policy. We understand that this policy is in
place for the well-being and health consideration of the school’s students and staff. We agree to keep our child
home as required by this policy. □yes
c)
I have read the school’s Statement of Cooperation, the Statement of Purpose, the Statement of Faith, and the
Parent-Student Handbook. □yes
d) I certify that the facts contained in this enrollment form are true and complete to the best of my knowledge and
belief. I certify that I am willing to abide by and uphold the policies of the school. □yes
e)
I give my permission for my child/children to be transported to and from SCA campuses for school related
activities. I give permission for teachers and chaperones to render medical aid or to seek professional medical
assistance for my child/children in the case of an emergency. I agree to hold Suffolk Christian Academy,
teachers, or any chaperone harmless for any accident or injury during participation of field trips, athletic events,
or other school related activity. □yes
________________________________________
(Father/Guardian signature)
(2017-2018)
__________________________________________
(Mother/Guardian signature)
5
Family Medical Consent & Emergency Information
To Whom It May Concern: I, ____________________________________, parent or legal guardian of
_____________________________________, do hereby give my consent to any hospital, paramedic,
etc. to administer the necessary treatment to my child in the event of an accident or serious illness. In
addition, I give consent to the staff of Suffolk Christian Academy to transport my child by ambulance at
my expense, if the situation warrants it. [Please use one form per student]
Student’s name: __________________________ Birthdate: ___________________________
Address: ______________________________________ Home Phone: ___________________________
Does child take medication regularly?
Yes
No
List medication and explain.
__________________________________________
Signature of Parent/Guardian
List allergies to food, medicines, etc.
____________________________
Date
A student’s prescription medication must be submitted to the school office in the original packaging. A
signed medication form from the parent indicating specific instructions for the dosage and the time the
medication is to be administered and a signed note from the student’s doctor is required before any
prescription medication may be administered. All over-the counter medications must be submitted to
the school office in original packaging together with a signed medication form indicating specific
instructions for the dosage and the time the medicine is to be administered.
In the interest of the student’s safety, the school office will notify a parent by telephone each time
any medication (prescription or over-the-counter) is dispensed to a student.
Physicians Name_____________________________________ Phone_____________________________
Address______________________________________________________________________________
Insurance Company__________________________________ Policy Number______________________
Illness Policy
For the well-being and health consideration of our students and staff, parents are asked to keep home any
student with fevers and contagious illnesses. Decisions about whether to send a child to school should be
made with the best interest of the school community in mind. According to the Virginia Department of
Health the following exclusions are required and must be adhered to.
A student must stay home with:
1. Fever (Student must not return to school until fever free for 24 hours)
2. Vomiting (Student must not return to school until 24 hours after last episode}
3. Flu symptoms, Diarrhea, or Colored nasal discharge *
4. Strep Throat (Student must be on medication for 24 hours before returning to school)*
5. Pinkeye (Student must be on medication for 24 hours before returning to school)*
6. Head Lice (Student must not return to school until treated and absence of infestation)*
If you know your child has been sick or has symptoms of a contagious illness, please do not send him/her to
school. In cases where a 24 hour waiting period is required and your child comes to school before that
length of time has elapsed, we will require you to come and pick up your child. Please understand 24 hours
does not mean the next morning. It means 24 hours from the time your child has overcome the illness (i.e.
stopped vomiting).
Parents must inform the school within 24 hours or the next business day after a child or any member of the
immediate household has developed any reportable communicable disease, as defined by the State Board
of Health, except for life threatening diseases, which must be reported immediately (*some examples are
listed above.
PARENTAL COMMITMENT: We have read and agree to faithfully comply with the school's illness policy. We
understand that this policy is in place for the wellbeing and health consideration of the school's students and
staff. We agree to keep our child home as required above.
In agreement with the Department of Social Services, we would like to remind our student families
in the school, Kingdom Kids Preschool, and Extended Care of the following illness policy:
Families are required to notify Suffolk Christian Academy within 24 hours in the event a student or
any member of the student’s immediate household develops a reportable communicable disease as
defined by the Virginia Department of Health.
Examples of Reportable Diseases Include:
 Chicken pox
 Conjunctivitis (Pink Eye)
 Diarrheal Diseases
 Fifth Disease
 Influenza
 Meningitis (Meningococcal & Pneumococcal)
 Norovirus
 Head Lice, Ringworm, Scabies
 Streptococcal Diseases including Impetigo, Scarlet Fever, and Strep Throat
See full list of reportable diseases at the Virginia Department of Health website: http://www.vdh.virginia.gov
Please sign and promptly return this form to the school office.
Student Name: ___________________________________________________ Date: ___________________
Parent’s Name: ___________________________________________________________________________
(2017-2018)
7
Statement of Purpose and Faith
Statement of Purpose: The purpose of the Corporation shall be to operate schools and other related agencies on the elementary and
secondary levels, training students in accordance with these fundamental goals of education: Our students will have a well-developed
knowledge of the Bible and commitment to Christ necessary to provide them with a Christian worldview and Christ-like character. Our
students will possess the academic skills sufficient to excel in today’s society and continue as life-long learners. Our students will be equipped
to engage their culture through Christ-centered living, service to others, and building the kingdom for the glory of God.
The following primary tenants of Christianity are the foundational beliefs upon which Suffolk Christian Academy is built and which
will be unapologetically taught throughout all grade levels. All board and staff members must subscribe to these foundational
beliefs. Other elements which have caused confusion and division in the past within the body of Jesus Christ will not be permitted
to destroy the unity of this school. Accordingly, we urge that an attitude of Christian love be expressed toward those holding
different views. Disputed secondary doctrinal matters will be referred back to the family and local church for clarification.
A. We believe there is one God, eternally existent in three persons—Father, Son, and Holy Spirit (Genesis
1:1, Matthew 28:19, John 10:30).
B. We believe in the deity of Christ (John 10:33), His virgin birth (Isaiah 7:14, Matthew 1:23, Luke 1:35), His
sinless life (Hebrews 4: 15, 7:26), His miracles (John 2:11), His vicarious and atoning death (1 Corinthians
15:3, Ephesians 1:7, Hebrews 2:9), His Resurrection (John 11:25, 1 Corinthians 15:4), His Ascension to the
right hand of God (Mark 16:19), His personal return in power and glory (Acts 1:11, Revelation 19:11).
C. We believe the Bible to be the inspired, only infallible, authoritative, inerrant Word of God (2 Timothy 3:16,
2 Peter 1:21).
D. We believe that God created man and woman in His own image (Genesis 1:26-27).
E. We believe that the term “marriage” has only one meaning: the uniting of one man and one woman in a
single, exclusive union, as delineated in Scripture. (Gen 2:18-25.) We believe that God intends sexual
intimacy to occur only between a man and a woman who are married to each other. (1 Cor. 6:18; 7:2-5;
Heb. 13:4.) We believe that God has commanded that no intimate sexual activity be engaged in outside of
a marriage between a man and a woman. We believe that any form of sexual immorality (including
adultery, fornication, homosexual behavior, bisexual conduct, bestiality, incest, and use of pornography) is
sinful and offensive to God. (Matt 15:18-20; 1 Cor. 6:9-10.)
F.
We believe in the absolute necessity of regeneration by the Holy Spirit for salvation because of the
exceeding sinfulness of human nature, and that men are justified on the single ground of faith in the shed
blood of Christ, and that only by God’s grace and through faith alone are we saved (John 3:16–19, 5:24;
Romans 3:23, 5:8–9; Ephesians 2:8–10; Titus 3:5).
G. We believe in the resurrection of both the saved and the lost; that they are saved unto the resurrection of
life, and that they are lost unto the resurrection of condemnation (John 5:28–29).
H. We believe in the spiritual unity of believers in our Lord Jesus Christ (Romans 8:9, 1 Corinthians 2:12–13,
Galatians 3:26–28).
I.
We believe in the present ministry of the Holy Spirit by whose indwelling the Christian is enabled to live a
godly life (Romans 8:13–14; 1 Corinthians 3:16, 6:19–20; Ephesians 4:30, 5:18).
I certify that I have read the above Statement of Purpose and Faith, Illness Policy and Statement of Cooperation
and agree to abide by each.
__________________________________________
Mother’s signature
Date
__________________________________________
Father’s signature
Date
Statement of Cooperation
DISCIPLINE: We believe that discipline is a necessary part of our child's education. We give
permission for the teachers and/or administration of SCA to make and enforce classroom
regulations in a manner consistent with Christian principles and discipline as set forth in
Scripture. We understand that we have the responsibility to support the authority, philosophy,
objectives, policies, procedures, and discipline of the school as established by school leadership.
(A copy of the student handbook is available on the school website at
www.suffolkchristianacademy.org and in the school office).
PARENTAL COMMITMENT: We agree that we will in no case complain to other parents, but will
register only necessary complaints with the teacher or administration following the Matthew
18 principle. We pledge our full cooperation to keep doctrinal controversy out of the school.
We understand that it is our responsibility to read the student handbook and agree to abide by
its established policies. We agree to support the school with our prayers and positive attitude.
We understand that if at any time the school determines that our actions do not support the
ministry, or reflect a lack of cooperation and commitment to the school-home partnership, the
school has the right to request the withdrawal of our child. We understand that the school
reserves the right to dismiss our student for lack of cooperation on the part of the student,
parent, and/or guardian.
PHILOSOPHY OF EDUCATION: We believe that the Bible holds us, as parents, responsible for
the education of our children. We enlist the help of Suffolk Christian Academy to assist us in
that effort. We agree to support the school's effort to train our child to be a follower of Christ
and to teach our child to view all of life from a Christian point of view.
We certify that we have read the above Statement of Cooperation, Statement of Purpose &
Faith, and Illness Policy and agree to abide by each. Please see our signatures on the previous
page.
(2017-2018)
9
Suffolk Christian Academy does not discriminate on the basis of race, gender, color, national ethnic origin in administration of
its educational policies, admissions policies, financial policies, and athletic and other school programs.
917 Carolina Road
Suffolk, VA 23434
757-925-4461 lower campus
Fax: 757-925-1194
757-809-6606 upper campus
Fax: 757-809-4898
Student Record Release Authorization
Name: ________________________________________________________________________________________________
Last
First
Middle
Current Grade: ____________________
Date of Birth: ________________________________
Applicant’s Current School: ________________________________________________________________________
School Address:
_____________________________________________________________________
_____________________________________________________________________
Phone Number: ________________________________
Fax Number: _________________________________
My child has applied to Suffolk Christian Academy. Please forward Suffolk Christian
Academy the following information on the above-referenced student:
 Final report cards (current and past two years)
 Health data (including immunization records and copy of birth certificate)
 Standardized test scores (past two years)
 Transcripts for students entering grades 8 through 12
 Teacher Evaluation Form (attached)
 Discipline Records
Thank you for your prompt attention to the above request.
_______________________________________
Date
________________________________________________________
Parent/Guardian Signature
Confidential Teacher Evaluation
Applicant's Name: ________________________________________________ Current Grade: ________
LAST
FIRST
MIDDLE
PREFERRED
Dear Teacher,
The above- named student is applying for admission to Suffolk Christian Academy. Your evaluation of the
student is an invaluable tool in the admission process. The applicant's file is not complete without the
return of this form. Please complete this form and return it directly to SCA at the address found on the
back of this form. Thank you in advance for your time and your comments.
EXCELLENT
ABOVE
AVERAGE
AVERAGE
BELOW UNABLE
AVERAGE TO RATE
FAMILY
Supports Child
Supports School
PERSONAL ATTRIBUTES
Peer Relationships
Respect for Authority
Responsibility
Creativity
Interest in Non-Academic Activities
Leadership Skills
Cooperation/Behavior
STUDY SKILLS
Effort
Completes Work
Works Independently
Attention Span
Study Habits
ACADEMIC PERFORMANCE:
Problem Solving
Procedures
General Knowledge
Academic motivation
Reading Ability
Writing Ability
(2017-2018)
11
Have any special accommodations or modifications been made to meet the needs of this student?
__ Yes __ No
If yes, please explain___________________________________________________________
Are you aware of any circumstances that may affect the child's success in school? __ Yes __ No
If yes, explain: ______________________________________________________________________
Do you recommend this student for honors level coursework in a subject area? __ Yes __ No
If yes, in which subject area____________________________________________________________
Has this student been sent to the office for disciplinary problems? __ never
__ infrequently
__ often
If so, please explain: ________________________________________
Is this student eligible to pass to the next grade? __ Yes __ No
Is this student eligible to continue in your school? __ Yes __ No
Please make any additional comments that would help us in making enrollment and placement decisions
and in meeting the future needs of this
student._____________________________________________________________________________
___________________________________________________________________________________
Name: _______________________________________________Position:________________________
Signature: _________________________________________________Date: _____________________
Address: ______________________________________________
City: _____________________State ___________ Zip_________
E-mail Address: ___________________________________
Please return within one week to:
Suffolk Christian Academy
Attn: Admissions Office
3488 Godwin Blvd.
Suffolk, VA 23434
Elementary Office: (757) 925-4461
Upper School Office: (757) 809-6606
KINDERGARTEN READINESS CHECKLIST
Name of Applicant________________________________________________ Date of Birth________________
Children develop at different rates and are not all ready for school at the same time. The following checklist will
help assess your child's readiness to begin kindergarten. We recommend that the parent work with the child in areas
in which he or she needs help.
Please note: Students must turn 5 years old on or before September 30 th of the year in which they enter
Kindergarten.
Social Skills
Personal Information
1. Knows his/her full name
__ Yes __ No
2. Knows how old he/she is
__ Yes __ No
3. Knows address and telephone number
__ Yes __ No
_____________________________
4. Knows mother and father’s first names __ Yes __ No
Parent's Signature
Gross Motor Skills
1. Runs, jumps and skips
__Yes __No
2. Walks backward
__ Yes __ No
3. Walks up and down stairs
__ Yes __ No
1. Uses words instead of being physical when
angry
__ Yes __ No
2. Speaks clearly so an adult can
understand him/her
__ Yes __ No
3. Plays with other children
__ Yes __ No
4. Follows simple directions
__ Yes __No
5. Expresses feelings and needs
__ Yes __No
6. Goes to the bathroom by him/herself
__ Yes __ No
7. Waits his/her turn and shares
__ yes __ No
8. Talks in sentences
__ Yes __ No
9. Inquires about surroundings
__ Yes __ No
10. Says "please" and "thank you"
__ Yes __ No
11. Can identify six parts of his/her body __ Yes __ No
12. Draws a picture of a person including head,
body, arms and legs.
__ Yes __ No
13. Understands concept words such as up, down, in, out,
behind, over
Fine Motor Skills
__ Yes __ No
1. Puts a 10- to 12-piece puzzle together
__ Yes __ No
14. Counts more than 10 objects
__ Yes __ No
2. Holds and uses scissors correctly
__ Yes __ No
15. Recognizes five colors
__ Yes __ No
3. Holds a pencil or crayon properly
__ Yes __ No
16. Tries to write his/her name
__ Yes __ No
4. Tries to tie his/her own shoes
__ Yes __ No
17. Recognizes his/her written name
__ Yes __ No
Parent's Signature_____________________________________________________________
(2017-2018)
13
Student Questionnaire
6th-12th graders
The following information is to be completed by the student:
Applicant’s name: ________________________________________ Candidate for grade: ____________
What church do you attend? _____________________________________________________________
Do you attend church regularly? Yes
No
Do you attend a youth group? Yes No
Have you made a decision to become a Christian and follow Christ? Yes
No
What does it mean to be a Christian? ______________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Why do you want to attend Suffolk Christian Academy? _______________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
What is your favorite Bible verse? Explain why it is so important to you: __________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
What is your favorite?
Subject: ________________________
Kind of book to read: ____________________________
TV show: _______________________
Music/Group: __________________________________
Websites: _______________________
Games: _______________________________________
Which subjects, if any, are difficult for you? _________________________________________________
Have you ever repeated a grade or class? Yes
No
Have you ever been suspended or expelled from school? Yes
No
If yes, share this information with us: ______________________________________________________
_____________________________________________________________________________________
Are you willing to uphold the biblical standards and morals of this school? Yes No
Do you understand that acceptance in to SCA requires that you must abide by Suffolk Christian
Academy’s policies and procedures as outlined in the Student Handbook and maintain satisfactory
academic progress, and failure to do so may result in your dismissal from the school? Yes No
_________________________________________
Applicant’s signature
________________________
Date
Pastor Reference Form
INSTRUCTIONS: Ask your pastor or associate pastor to complete the information below. If current circumstances
prevent you from obtaining a pastor’s reference, please explain here: ____________________________________
_____________________________________________________________________________________________
Family Name_____________________________________________________________
Family Address _______________________________________________________________________
________________________________
Child’s Name
Grade
________________________________
Child’s Name
Grade
________________________________
Child’s Name
Grade
________________________________
Child’s Name
Grade
________________________________
Child’s Name
Grade
________________________________
Child’s Name
Grade
To be completed by a Pastor or Associate Pastor:
1. How long have you known the family? _____________________
2. Church membership: ____Both Parents ____Father ____Mother ____Neither Parent
3. Describe the family’s church attendance:
____Active/Regular ____ Occasional ____Often ____ Seldom ____Never
4. Is this family active in church beyond Sunday attendance?
Yes
No
If yes, explain: _____________________________________________________________
5. Is/are the child/children active in the children’s or youth program?
Yes
No
6. Do you consider the child/children open to spiritual instruction?
Yes
No
7. Does this family present a lifestyle that is a positive testimony for the Lord?
Yes
8. Is this family interested in their child (ren) knowing and walking with the Lord?
9. Does this family command respect and obedience from their child/children?
No
Yes
Yes
No
No
10. Please explain any concerns that Suffolk Christian Academy should consider relative to the
admission of this family: ___________________________________________________
________________________________________________________________________
11. Do you recommend the child/children in this family for admission?
Yes
No
Name of Church: _____________________________________ Phone: ____________________
Church Address: _________________________________________________________________
Pastor’s Name: __________________________ Pastoral Position: _______________________
Pastor’s Signature: _____________________________________ Date: ___________________
All information provided will remain confidential and is used solely for the purpose of admissions.
Please promptly return this form to: Suffolk Christian Academy●3488 Godwin Blvd● Suffolk, VA● 23434
(2017-2018)
15
SUFFOLK CHRISTIAN ACADEMY
TUITION & FEES
2017-2018
Application Fee & Re-enrollment Fee
New Student Application
Re-enrollment Fee
$250 per student
$250 per family/$300 after March 31st
Total Tuition & Composite Fee
First payment due on July 1,2017 • S emi- annual payments are due on July 1, 2017 & January 1, 2018
• Subsequent monthly payments are due on the first of each month
Elementary School (K-5)
$6,075 per student
Middle School (6-8)
$6,375 per student
High School (9-12)
$6,675 per student
Family Cap Option
Tuition & Composite Fees
Family Cap Option:
Composite fees:
$14,600 per family, plus:
$425 per student (K-5)
$525 per student (6-8)
$625 per student (9-12)
Additional Fees
Athletic Fee
$125 per team sport, due beginning of season
Graduation Fee
$100 per student, due March of Senior year
AP Testing Fee
$97 per student for each AP course
Withdrawal Fee
$2,000 per student, due at time of withdrawal
NEW STUDENT APPLICATION FEE: PER STUDENT (Non-refundable)
The New Student Application Fee is required at the time of application to SCA. This fee covers costs associated
with the application process and admission testing. This fee applies to all new students who are enrolling in K-12th
grade and students who are transferring from another school or homeschool.
RE-ENROLLMENT FEE: PER FAMILY (Non-refundable)
The Re-enrollment Fee is required at the time returning students re-enroll. Once the re-enrollment form and
fee are received, the student’s seat is reserved. Priority will be given to the student when filling classroom seats;
however, a contract must be entered into to finalize this process. Families are not responsible for composite &
withdrawal fees by simply re-enrolling a student.
COMPOSITE FEE: PER STUDENT (Non-refundable)
The Composite Fee covers most books, supplies, educational supplements, and program enhancements.
The book portion of this fee is a prorated fee, since some books are consumable and some last more than one
year. Students retain consumable books only at the end of the year. If a student withdraws prior to the start
of the school year, the fee is not refunded, and any books or supplies are forfeited.
Fees are as follows: $425 (K-5); $525 (6-8); $625 (9-12)
FACTS Tuition Management: FACTS is the largest provider of tuition payment plans in the industry, giving
families a better way to manage education costs over time. With a FACTS Tuition Payment Plan you can choose
a convenient payment option to suit your needs. New families will sign up for FACTS to make their tuition
payments as part of the enrollment process. FACTS provides this service to families for an annual fee,
which is currently $45.00.
MID-YEAR ENTRY: When a student enters the school during the year, composite fees will be charged in
full (see fees above) and tuition will be charged to each month the student is registered (regardless of the
number of days in attendance the first month) on the basis of one-tenth (1/10th) of the annual tuition.
WITHDRAWAL FEE (PER FAMILY):
A family who withdraws a student after the start of school is
responsible for paying a $2,000.00 withdrawal fee per student as well as composite fees and tuition for each
month, including any portion of a month the student was in attendance. O n c e a f amily has signed a
contractual agreement with SCA, the family has until June 1, 2017 to rescind the contract to avoid
financial responsibility for the composite fee & the $2,000 withdrawal fee per student.
LATE PAYMENT: (1) In the event that payment is not received within (15) days of its due date, there will
be a late charge of $35.00 added to your account balance. (2) In the event of default of the payment of any
installment, in addition to paying any late charge, the family will be charged interest on the unpaid balance
of 1% per month from the date of default plus all costs of collection and legal fees. (3) In the event of default,
Suffolk Christian Academy has the right to demand total payment of any remaining balance and/or
withdrawal of the student from SCA.
ATHLETICS: In effort to provide the best support to student athletes, parents of athletes are required to
volunteer twice per season (per sport participation) in concessions o r gate duty. Non-participants will be
charged a $50 fee.
Before & After Care Program
Registration Fee (*required for use)
$60.00 initial registration per student
$40.00 re-enrollment per student
Before Care Only*
$175.00 per student
After Care Only*
$200.00 per student
Full-time Before & After Care*
$280.00 per student
Part-time Before & After Care*
$180.00 per student
$135.00 per student
$440.00 per family
3 days
2 days
Family Cap for Before & After Care*
Single Day Rate*
(4 day limit per month)
Full Day Rate*
Before Care
After Care
(Teacher workdays/Conferences)
$15.00 per student
$20.00 per student
$30.00 per student
BEFORE & AFTER CARE PROGRAM: Please note: Any student participating in this program
must, by law, register for the Before & After Care Program. This includes single day and full day
use. Services are available for each day the school is open during the school year. It is also
available on early dismissal days, teacher workdays, and conference days, except in special
circumstances with prior notification. Special effort is made to cover portions of breaks based on
needs and availability of staff; however, services are not guaranteed. Full day rates apply.
Services are not available on school holidays. Summer camp is available.
Student Support Program
**Service provided by licensed NILD therapist
**Placement
Testing
Resource Fee
Explode the Code
Tutoring
Individualized
Instruction
**Educational
Therapy
Roe-Burns
Woodcock-Johnson
Search & Teach Scan
Upon enrollment, for educational resources
Program for spelling & phonics intervention
Subject level tutoring
Individualized course instruction in small
group setting (4 students or less)
NILD Therapy 80 minute session (2x/week)
Search & Teach Program
$60
$100
$25
$100
$110 per month
$25 per hour
$1,525 per course
$3,550 per year
$1,950 per year
All families must meet with M s . K e s s l e r , the school's financial
administrator, to sign an Enrollment Contract before your student’s
enrollment is finalized.