K-12 Student Application Name * First/Middle/Last First Name Last Name Date of Birth * MM DD YYYY Gender * Male Female Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Education Current School * Grade in 2024-2025 year * Parent / Guardian Info Full Name * First Name Last Name Phone Number * (###) ### #### Email * Full Name * First Name Last Name Phone Number * (###) ### #### Email * Additional Siblings Registering Please Fill out One Application Per Student Additional Sibling(s) Registering * Please Enter Name, Relationship, Grade Statement of Faith Is Your Student a Christian? * Yes No If yes, does your student attend church? * Yes No NA Where? * Emergency Contacts Name * First Name Last Name Phone * (###) ### #### Name * First Name Last Name Phone * (###) ### #### Additional People Allowed to Pick up Your Child * Please include each individual's first and last name and phone number. Are there any medical, spiritual, or other issues that EPEC needs to be aware of with your child? * Dress Code -Students are not allowed to wear clothing that exposes their shoulders. Straps on shirts should be at least 1 in. -Students are not allowed to wear clothing that exposes their back. -Students are not allowed to wear clothing that exposes any undergarments. -Students are not allowed to wear clothing depicting anything evil. -Students are not to wear shorts, skirts, or pants with holes that expose legs above mid thigh. -Students are not to wear clothing that exposes their midriff (stomach area). *Dress Code violations are at the discretion of EPEC staff * I agree to have my student abide by the EPEC dress code. I understand that if my child violates the EPEC dress code I may be called to bring suitable clothing or my child may need to wear clothing provided by EPEC. I also understand that if my child repeatedly violates the dress code he/she may be sent home and/or given consequences at school (detention, trash duty, campus clean up, etc.). Cell Phone Policy * EPEC has a no cell phone policy. Students are not to use their cell phone, unless given permission by staff, during the school day. Cell phones are to be turned off and put in a zipped compartment in their backpacks. Students will first receive a warning if caught using their phone. If caught again, the student’s cell phone will be taken away and a parent will have to pick up the cell phone from the office or the teacher. If the cell phone policy continues to be ignored, the student will not be allowed to carry a cell phone while attending EPEC. I agree to the cell phone policy and understand the consequences if my child uses their cell phone without permission. EPEC Tuition * Tuition for EPEC may be paid in full or divided into 10 equal payments. Tuition for EPEC is due no later than the 5th of each month. Payments received after the 5th will incur a $25 late fee. Students may be asked to leave EPEC if tuition payments are more than 30 days late. I also understand that I am required to give a 30 day written notice if I decide to withdraw my child from EPEC or I will be charged the normal tuition rate. I agree to pay tuition on time and understand that if I do not, I will incur a $25 fee. I also understand that my child may be asked to leave EPEC if tuition is more than 30 days late. I also agree to give a written 30 day notice if I decide to withdraw my child from EPEC or I will be charged the normal tuition rate. Parent Responsibility * I understand that I am ultimately responsible for my child’s behavior and education. EPEC is a center designed to come alongside families and work together to help children grow into the person God created them to be, as well as help them succeed academically. If this partnership is no longer working for EPEC or myself, I understand that it may be terminated. Christian Values / Teaching The main goal of EPEC is for our families to come to know Christ Jesus in a powerful and unique way. One of the ways we help our students do that is through morning prayer, chapel, reading our bible, following Christian values/teachings, and discussing theological and spiritual topics. We expect students to arrive on time to prayer and participate. * I understand that EPEC is a Christian Educational Center. Students are required to attend morning prayer, chapel, read their Bible, follow Christian values/teachings, and discuss theological and spiritual topics. By signing below, I certify that my answers are true and complete to the best of my knowledge. * First Name Last Name Name * First Name Last Name Date * MM DD YYYY Thank you!
