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Revised February 2016 2016-2017 Umpqua Valley Christian School Open Enrollment Packet Instructions: Please fill out all forms completely to ensure that your enrollment is not unnecessarily delayed. 1.) Initial to agree with all required statements. Any statements not initialed will indicate disagreement with statements and may influence the enrollment process. 2.) Review Tuition Chart. 3.) Select your Tuition Payment Plan. 4.) Return this Enrollment Packet with the enrollment fee of $300 to the school office. 5.) Pre-School, Kindergarten, and 1st graders, Please submit your birth certificate and immunization record. Umpqua Valley Christian School (UVC) 18585 Dixonville Rd. Roseburg, OR 97470 Phone: 541-679-4964 Email: [email protected] Umpqua Valley Christian School, 18585 Dixonville Rd., Roseburg, OR 97470 Ph. 541-679-4964

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Page 1: 2016-2017 Umpqua Valley Christian School Open Enrollment Packet Open... · 2016-04-05 · Revised February 2016 2016-2017 Umpqua Valley Christian School Open Enrollment Packet. Instructions:

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2016-2017 Umpqua Valley Christian School Open Enrollment Packet

Instructions: Please fill out all forms completely to ensure that your enrollment is not unnecessarily delayed.

1.) Initial to agree with all required statements. Any statements not initialed will indicate disagreement with statements and may influence the enrollment process.

2.) Review Tuition Chart.

3.) Select your Tuition Payment Plan.

4.) Return this Enrollment Packet with the enrollment fee of $300 to the school office.

5.) Pre-School, Kindergarten, and 1st graders, Please submit your birth certificate andimmunization record.

Umpqua Valley Christian School (UVC) 18585 Dixonville Rd. Roseburg, OR 97470 Phone: 541-679-4964 Email: [email protected]

Umpqua Valley Christian School, 18585 Dixonville Rd., Roseburg, OR 97470 Ph. 541-679-4964

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CORE STATEMENTS

Mission Statement – Umpqua Valley Christian School exists to partner with parents to educate and disciplestudents from a Biblical worldview.

Belief Statements - We believe the Scriptures of the Old and New Testaments to be the complete and inspiredword of God without error in the original writings and that they are the supreme and final authority for faith and life. (II Timothy 3:16)

We believe in one God, eternally existing in three persons: Father, Son and Holy Spirit. (Deuteronomy 6:4, Matthew 28:18-19, John 1:1, John 14:16, Philippians2:6-11)

We believe that Jesus Christ was conceived by the Holy Spirit, born of the Virgin Mary, and is fully God and fully Man. (Matthew 1:18, I Timothy 3:16)

We believe that man was created in the image of God; that he sinned, causing not only physical death but also spiritual death, which is separation from God; that all human beings are born with a sinful nature. (Genesis 1:27, Genesis 3:17-19, Romans 5:12)

We believe that the Lord Jesus Christ died for the atonement of our sins, according to the Scriptures, in our place, and that all who believe in Him are forgiven and eternally saved. (John 3:16, Romans 5:8, Romans 10:9-10, I Corinthians 15:3-4)

We believe that Jesus arose bodily from the dead, that He ascended into heaven, and that he is now, our High Priest and Advocate. (Matthew 18:5-6, Acts 1:2, Hebrews 4:14-16, I John 2:1)

We believe that all who, by faith, accept the offer of salvation through the Lord Jesus Christ are born-again of the Holy Spirit, and thereby become children of God. (John 1:12-13, John 3:16, Galatians 3:26) We believe in the “blessed hope”, that Jesus Christ Himself will soon return for us. The believers who have died shall be resurrected and those alive shall join them in meeting Him to live eternally with Him in His presence. (Titus 2:13, I Thessalonians 4:13-18, John 14:3)

We believe that those who refuse to place their trust in Jesus shall be resurrected to face judgment and shall be eternally punished. (Revelation 2:5-7, 11-15)

I agree with the UVC Core Statements. ________ (Parent Initial)

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BIBLICAL WORLDVIEW CURRICULUM STATEMENTS The fear of the Lord is the beginning of wisdom, not only in our educational philosophy, but also for each discipline of study. Education is not made Christian by merely adding a course in Bible, reading Christian text, or by beginning a class in prayer. If the course content or teaching method is humanistic, Christian supplements will do little to change the orientation. A Christian curriculum must derive its fundamental principles from the inspired Word of God and work these out in a self-conscious manner. A Christian curriculum provides parents and students and staff with these principles as well as the content and skills which enable them to develop a biblical worldview in each subject. The following is an overview of such a curriculum. Biblical Studies Foundational to the Christian curriculum is the study of the Bible. Every UVC staff member must be mastered by the Word of God before they can properly teach students to be mastered by the Word of God. The goal of Christian education is for students to master the Word of God in order to gain the ability to evaluate the writings and purposes of men from a biblical perspective. Bible study focuses the student’s attention on the inspired text of the Bible as they are taught to understand it correctly. Its purpose is not the mere study of religion, nor even historical studies of Bible characters, but to arrive at a unified understanding of the biblical system of truth. It is this system of truth that provides the fundamental principles of a Christian worldview which must be applied to every area of life and thought in order to make biblically sound decisions. To properly learn each subject, the student must not only be able to read, but he must also have the standard by which to judge what he reads. Therefore, the very first book a child should be taught is the Bible. The Bible is the mind of God revealed to man. From it we learn about the creation, the fall into sin, and God’s gracious plan of redemption. It is this knowledge which provides the key to right thinking and enables the student to correctly interpret all he learns in the light of God’s truth. Culture, Art, and Technology The arts and technology are gifts given to men by God. When an artist paints a picture, or a musician composes a song, or an architect designs a building, or an engineer designs a machine, each is using his God-given talent. Every gift should be used to reflect the wisdom of its Giver and imitate the beauty and usefulness of His creative work. The humanistic worldview sees culture, art, and technology as existing only for self-expression, human enjoyment, and selfish vanity. The non-Christian uses culture as a way to revolt against God and glorify himself. He thinks that he can create out of nothing something totally original. When man creates, he is not creating something absolutely new, but merely discovering a potentiality which has existed from the beginning. Its proper use becomes a blessing from God for the benefit of men, while its misuse becomes a curse for the destruction of men. Because the arts and technology create works that express thought and emotion, they exert a moral influence on one’s behavior. The arts and technology can be powerful forms of religious fellowship; religious because thoughts, emotions, and actions are always moral, and fellowship because of the sharing between artist and audience. For the Christian, this imposes a serious responsibility. It means that we are not to enjoy a specific type of art and technology that promotes thoughts, emotions, and behavior that is contrary to the Word of God. The Scripture says, “What fellowship has light with darkness?” (2 Corinthians 6:14). Instead, students should be taught to enjoy art and develop technology that reflects the glory of God’s creation and ministers to others. The student is to develop his talents in harmony with God’s truth and law. Furthermore, the Christian should use both the arts and technology, either directly or indirectly, to promote the Gospel of Jesus Christ and thereby promote a biblical understanding of God’s imperative to make disciples of all nations. In so doing, the student will learn how to employ his skills to advance the kingdom of God on earth for God’s honor and glory. Economics God is the possessor of the earth, the source of all wealth. He owns it, and gives it to whomever He wills. He also ordained laws to govern human economics. God has given men the right to own private property, the right to choose an occupation, the right to make a profit, and the right to decide how earnings should be spent. Yet because God owns all things, the student should be taught to exercise these rights as God’s steward. According to Scripture, it is not the duty of civil government to regulate the economy except as it regards the enforcement of God’s law against stealing. God’s law affirms the right of private property and profit from labor. To exercise these God-given rights, Scripture provides guidelines for an economic system that glorifies God and shows charity toward the needs of others. Such an economic system is based upon hard work, competition, and the risks of the marketplace. These factors compel sellers to use their skills and economic resources more carefully, which produces a higher quality of goods and services at very reasonable prices. The proper role of civil government is to serve as a referee, praising good and punishing evil in the marketplace according to God’s law.

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Wealth is not just a result of economic shrewdness. Economic prosperity is possible only by God’s blessing upon the lawful use of labor and profit. Productive harmony in the marketplace is possible only through the grace of God which inspires men to obey His law in their hearts and minds. To the extent that men understand and obey God’s law in the economic realm, that is, when Christianity has a significant bearing on economic life, men will respect each other’s property, refuse to steal from or cheat one another, abide by contracts, and, when in charge of a corporation or elected to public office, they will not use their power to amass wealth for their own selfish ends. Geography For man to rule over the earth as God has commanded, he must have a practical knowledge of geography. The study of geography must begin with the Bible. Here God reveals that the earth consists of separate but interrelated parts which form a unified whole. During the worldwide flood in the days of Noah, the surface and appearance of the earth were greatly changed. With this important knowledge, the student can properly study the great continents and oceans, their particular characteristics, their many natural resources, the variety of climates and weather patterns, and God’s ingenious ecological balance over all of it. We also learn in Scripture of the origin of the nations, how God scattered mankind at the Tower of Babel by confusing man’s language, and thus, laying the foundation for the gathering of the nations through the nation of Israel and ultimately through Jesus Christ. The student is then able to properly study the geographical circumstances of the various nations, both ancient and modern. He studies their locations, their natural resources, physical environments, and general climates as planned by God. He learns how these geographical traits affect the nations’ economies, their position in world trade, their military defense capabilities, and their independence of, or dependence upon, other nations. The study of geography plays an important role for Christian students as they learn about the worldwide advance of the kingdom of God, and how they may help promote Christian missions to fulfill Gods’ plan to reach every nation and language group in their own unique geographical context with the gospel message. Government The study of government (political science) and politics must be grounded in the Word of God. In studying civil law and government, we need God’s infallible standard in order to distinguish justice from injustice. Because civil government enacts laws, it is concerned with deciding right and wrong. Right and wrong, however, have to do with morality, and ultimate morality is found in religion -God. This means that civil government by its very nature is a religious/divine institution. The Old Testament reveals God’s system of law for civil government. At Mount Sinai, through the prophet Moses, God gave to Israel an entire system of civil law and government. In the books of Exodus, Leviticus, Numbers, and Deuteronomy, we see a complete system of law with due process, a federal system of government with three branches, and a separation of powers with a system of checks and balances. The student who learns this system has the proper criterion by which to analyze human governments of the past and present as to their structure, laws, and policies. This knowledge will provide the student with understanding necessary for intelligent Christian living in light of his right to vote, and stimulate him to promote a responsible government regulated by God’s law. Health and Physical Education The purpose of health and physical education is to care for our bodies to the glory of God. A healthy body enables one to serve God diligently and perform the duties He commands. Therefore, principles of proper diet, exercise, and rest should be taught for maintaining good health to the glory of God. Physical education also helps prepare students for responsible leadership and effective work. Students should be taught to play and labor for God’s glory, not our own. Due to sin, people are naturally inclined toward laziness. Consequently, physical exercise and sports, when combined with sanctification, can play an important part in developing self-discipline. Through competition, students are taught the importance of playing by the rules, accepting direction from those in authority, using skills in harmony with others, and being gracious in victory as well as in defeat. History The Bible clearly reveals that God is the Lord of history. He governs all nations and peoples by means of His providence. He acts indirectly and directly in history through blessings and judgments upon the earth (Deuteronomy 28). The prophecies recorded in Scripture, many of which have been fulfilled, demonstrate that history has not only been planned by God but proceeds according to His purpose. For this reason, all history—ancient, medieval, and modern—must be seen as the sovereign rule of God over the affairs of men. All men and nations are accountable to Him. The lessons of history warn students that God’s curse on unfaithfulness and His blessing on faithfulness will surely come to pass.

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A proper understanding of history is founded upon the key events of creation, man’s fall into sin, God’s scattering of the nations, and His plan to gather the nations through the forming of the nation of Israel and its ultimate promised Messiah, Jesus Christ through His work on the cross. Creation sets the stage for history. With Adam’s sin history becomes a conflict between the children of light and the children of darkness. Because God’s plan is to sum up all things in Christ (Ephesians 1:10), history has one purpose. Consequently its meaning and interpretation must be understood in terms of Christ. History is more than a chronicle of names, dates, places, and events. History is the study of the moral or covenantal relationship between God and man in time. It centers on the redemptive work of Christ and how He is building His church. All earlier events must look forward to the cross. All later events must be viewed as the hand of God directing history toward the final victory of the risen Christ at the end of the age. And in this context, UVC students should be equipped to spread the good news throughout the world. The study of history focuses on the unfolding of world history with a special emphasis on the shaping of Europe and America by God’s providence and the efforts of Christians as they applied God’s Word to their nation and culture. Students should be equipped to study the vain attempts of apostate men to build the kingdom of man. Those who have attempted to destroy Christ and His Kingdom in order to reestablish pagan ideas in the civil, ecclesiastical, and academic disciplines will have their lives and works evaluated by the Bible. This comparison gives insight to us as we work by God’s grace in our day to restore God’s Law-Word to our lives, families, nation, and culture in obedience to Genesis 1:26-28 as modified by Matthew 28:19-20. God’s people must diligently work and “occupy,” as they advance His kingdom on earth through the gospel for His honor and glory. Language and Literature In the beginning, God spoke and it came to pass. The three persons of the Trinity have spoken to each other eternally. When God created man in His own image, He gave him the gift of language. The Bible tells us that after the Great Flood, the whole earth used the same language. Men desired unity apart from God, however, when they built the Tower of Babel. Seeing this, God confused their one language by changing it into many languages and scattered them abroad over the face of the whole earth. Language thus originated with God, and is to be learned for reaching those with the gospel in the language God has determined for each of them, all for His glory. Men in their sin misuse and corrupt this gift and learn language primarily for financial gain. To discern the proper use of language learning, we need to study God’s ultimate plan to reach the world through the languages He has created in Genesis chapter 10. It is only from the Bible that we come to know the true motivation for learning language. Reading and writing are foundational skills each child must learn. Without reading, they cannot study the Bible for themselves. These skills are also basic to learning all other subjects in the light of God’s Word. They must be taught to read, write, speak, study, and think in terms of the Word that makes language and life meaningful. They must develop the linguistic abilities that God has given them to glorify Himself. The teaching of phonics, therefore, is very important. Language skills are not neutral, but must be oriented toward reading, writing, and speaking the truth in love. Because language is thought expressed, and thoughts are never neutral, all literature has a religious/divine point of view. When reading any kind of literature, the question should therefore be asked: Is the author Christian or non-Christian? If non-Christian, from what religious point of view is he writing? Most importantly, how does the author’s message compare with what the Bible teaches? Students must learn to read and evaluate all human literature from the perspective of Scriptural truth. While it is important to help acquaint students with the great literature that has helped shape Western civilization, the study of such great books must be subject to the greatest book—the Bible. After learning the Bible properly, the student will be equipped to judge the words of human authors by the Word of truth. The student should learn to prize not only great classics, but distinguish Christian classics from the classics of unbelief. The great classics of the Christian heritage will inspire and challenge both teacher and student to follow Christ more completely. Mathematics As Trinity, God is the reason there is both unity and diversity in creation. This is the basis for unity and differentiation in mathematics. The Bible teaches us that the Creator is a God of order (1 Corinthians 14:33). As we study the created universe we are impressed with its mathematical order. Creation is governed by mathematical laws which reflect the character of the One who made it. Many of the laws of creation are described in terms of mathematics. When presented with the marvelous precision in nature and physics, the student should be led to marvel at God’s mathematical ingenuity. Mathematical principles never vary; formulas and equations always exhibit flawless consistency. Consequently, as a tool for studying God’s creative handiwork, mathematics helps discover God’s creation laws and patterns. It is impossible for us to understand creation without God’s gift of mathematics, for we would not have the means of measuring His world. Mathematics is a tool to help men rule over the earth under God. All callings in life demand planning, calculating, and evaluating in order to carry out God-given responsibilities. Mathematics plays an important role, whether it be in business, medicine, engineering, art, science, etc. The Christian student should thus master this wonderful gift to advance Christ’s kingdom on earth.

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Science Science is the study of God’s creation. The facts of creation can be understood properly only by looking at them through the lens of Scripture (Hebrews 11:3). By studying science as God’s creation the student learns to see God’s awesome power, the beauty of His handiwork and design reflected in every creature. Because creation was brought into existence by God’s wisdom, and man was created as a part of it, he is called to understand and subdue it for His glory. In Eden God assigned man his task of ruling over the animals and plants and keeping the earth. Under God’s authority he is to cultivate, care for, and develop each aspect of the world for God’s glory. Adam pursued scientific education when he learned to cultivate the soil, plant and dress the trees and vegetation, study the animals, and give each a special name that described them. To rule over the earth as God commanded, the student must similarly acquire an organized and systematic scientific knowledge. By studying both God’s physical laws and His creatures, students will learn to apply this knowledge in accordance with His holy will. As they grow in their knowledge and appreciation of each new discovery about God’s world, they should acknowledge that God is the One who made it and learn to subdue and care for creation in the right way. To do this, the study of science must be subject to the Word of God. Creation must never be seen as something independent of its Creator, about which men can study without reference to Him. The belief of an Intelligent Designer avoids the fundamental trap of the evolutionary worldview and “science falsely so called” (1 Timothy 6:20). Society Biblical sociology (social studies) begins with God, who exists in an eternal relationship between the persons of the Trinity. Because the Bible stresses God’s unity and plurality as equally ultimate, we find that it does not place the human individual or the corporate society above each other. Thus Christianity has the only solution to the problems of humanism as it careens between individualism and collectivism. In His infinite wisdom, God instituted the fundamental social relationship—the family—at creation. From this basic institution, all other social orders have developed according to His providence. He ordained the state, the church, and the family. Each social sphere is directly responsible to God and each has rights that must function within the sphere of authority given to it by Him. These coordinate rights and responsibilities have been clearly marked out in His Word. The Bible also provides social facts which should be taught. For example, the social structures of the Old Testament covenant community of Israel demonstrate God’s purpose for each society, and contrast them with pagan society. A biblical presentation of the social order is needed to address effectively the current corruption of society. Biblical law provides the tools for analyzing the various social structures of different nations and peoples. Conclusion Having analyzed God’s original order and the perversion of that order by apostate man, staff and the student should be led to see God’s provision for an alternate society. What sin has distorted in the social order established by God, He restores by His grace. Students should be instructed in how Christ and his redemption not only restore the relationship between God and man but, as a result, the social relationships between men, women, children, UVC staff, races, and nations. The Christian family and the Christian community—the church—should be presented as the alternate society in the midst of chaos.

I agree with the Biblical Worldview Curriculum Statements. ________ (Parent Initial)

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STUDENT CONDUCT, PHILOSOPHY, AND BEHAVIOR STANDARDS Umpqua Valley Christian School is a discipleship school, committed to using discipline in a godly way to help students grow and mature spiritually, academically, emotionally, and physically. It does not mean that discipline is the sole focus of our school; rather, it is one piece of a scripturally balanced approach to educating and training students in a culture that is increasingly hostile to accountability, structure, and order. General Behavior Standards Conduct honoring to Christ is expected of all students at Umpqua Valley Christian School. Students are expected to adhere to the rules and regulations, which are in keeping with the purpose of an educational institution. Each student is a representative of our school wherever he may be. Students are expected to:

1. Willingly abide by attendance policies, expectations for conduct, dress code, and classroom or athletic team rules. 2. Accept responsibility for their behavior 3. Perform to the best of their ability in all areas 4. Respect those in authority, fellow students, and the property of others 5. Students are expected to attend all assigned classes, chapels, and assemblies. Students are expected to arrive

on time, bring all the necessary books and materials, to be attentive, to participate, and to apply themselves diligently in order to learn.

6. Students are expected to be obedient and respectful to all their teachers and chapel leaders at all times. 7. Students are not to bring any candy, food, or drink into any classroom or chapel service; they are not to eat or

drink in any classroom (that are not designated eating areas) or chapel services except as an official school function. Gum chewing is also not allowed on campus.

Serious Offenses As students of Umpqua Valley Christian Schools, your behavior and attitude directly or indirectly affects your public Christian testimony 24 hours per day, 7 days per week, 365 days a year. As such, the following behaviors are strictly forbidden at all times, on or off campus. Your participation in these or similar behaviors may result in severe discipline, up to and including suspension or dismissal from Umpqua Valley Christian Schools.

1. Physical fighting. 2. Possession and/or use of weapons on school property; use of weapons in any dispute. 3. Stealing or attempting to steal. 4. Deliberate destruction of church, school or personal property, or acting as an accomplice to such action. 5. Possession, use, disbursement, or sale of narcotics, alcohol, illegal use of tobacco or any illegal substance;

possession, use, or disbursement of any controlled substance without a doctor’s prescription. 6. Lying or cheating in any form. 7. Profane or obscene language. 8. Moral behavior that defiles the testimony of Jesus Christ and Umpqua Valley Christian Schools. 9. Possession, use, or disbursement of pornography, or any vile, obscene, or profane literature. 10. Possession, use, or disbursement of material, devices, or products that endorse, encourage, or promote immoral

behavior. 11. Endorsement and/or promotion of anti-Christian philosophies or behaviors. 12. Disrespect or attitude of rebellion towards the absolute Truth of God’s Word and to the presenters.

I agree with the Student Conduct, Philosophy, and Behavior Standards.

________ (Parent Initial)

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DRESS CODE POLICY 1.0 PURPOSE

As a Christian institution, we believe it is vitally important for our students to learn how to apply God’s word to every area of life. We believe the focus should be on teaching principles that apply in dress code and grooming issues. The goal is to enable students to dress in a spirit or attitude that reflects the values of Jesus.

2.0 POLICY The principles from God’s word that we believe should govern our dress and grooming.

2.1 Students should honor the Lord and their parents in their dress grooming. (I Corinthians 10:31, Ephesians 6:1-3) 2.2 Students should dress and groom in a modest way. (I Timothy 2:9, Romans 14:13-15) 2.3 Students should dress and groom in a manner that focuses on learning and being a student. This means

a student should dress in a manner that is appropriate to what they are doing, just as an athlete wears a uniform for a particular sport. (II Timothy 2:4-5)

2.4 Students should dress and groom in a gender appropriate manner. (I Corinthians 11:14) 2.5 Students should not be trying to focus attention on themselves by their dress or grooming. Nor should

students dress or groom in a manner that would be a hindrance to the work of the gospel. 2.6 Students should not dress or groom in a manner that would be a stumbling block to others. Literally

students should not dress in a way that would cause another student to disobey God. (Romans 14:13) 2.7 Students should be humble and teachable in regards to their dress and grooming. (James 4:6) 3.0 GENERAL

3.1 Standards for boys and girls 3.1.1 Clothing must be neat, clean, in good repair, and appropriately sized. (2.2, 2.3, 2.5) 3.1.2 Hats may not be worn in class. (2.3) 3.1.3 Footwear must be worn at all times. (2.3) 3.1.4 Unnaturally colored hair (blue, green, etc.) is not acceptable except for spirit week. (2.2) 3.1.5 Visible tattoos may not be worn. (2.5) 3.1.6 Emblems or jewelry with new age or occult symbols, punk or rock slogans that are secular,

worldly, or carnal may not be worn. (2.1) 3.1.7 There are to be no undergarment-type clothing showing, such as bras, sports bras, boxers, or

long underwear. 3.1.8 No overalls may be worn at the Junior/Senior High School campus. 3.1.9 No body piercing is allowed. (2.3)

3.2 Standards specifically for girls

3.2.1 Blue jeans may be worn but there may not be any skin showing between pants and the top. (2.2) 3.2.2 Blouses, skirts, or dresses that can be seen through may not be worn. Knit shirts may be worn;

however no logo T-shirts may be worn. (2.2) 3.2.3 Dresses and skirts must be no shorter than the kneecap. If the outfit has a slit, it must be modest

and no higher than the knee. Necklines must be modest. (2.2) 3.2.4 Approved hemmed shorts must be no shorter than mid-thigh and must be modest. Athletic shorts

are not approved shorts. (2.1) 3.2.5 Girls may wear a total of 4 earrings. (2.3, 2.5) 3.2.6 Banquet dress length must comply with the school dress code and the neckline must be modest.

(2.2) 3.2.7 On Chapel day, girls must wear a dress or skirt and blouse. (2.3) 3.2.8 In order to gauge modesty, all clothing must be observed in movements such as walking, bending

over, and sitting. Simply observing the clothing from in front of a mirror will not be a sufficient guide to modesty.

3.3 Standards specifically for boys 3.3.1 If shirts have a hem that is to be tucked in, they must be tucked in. School and brand names or

symbols are acceptable. Plain white T-shirts are to be worn only as undershirts. (2.1, 2.2) 3.3.2 Approved hemmed shorts must be no shorter than mid-thigh and must be modest. Athletic shorts

are not approved shorts. (2.2) 3.3.3 On Chapel day a tier, button-up shirt, and slacks must be worn. (2.5, 2.6) 3.3.4 Earrings may not be worn. (2.5, 2.6) 3.3.5 Hair must be neatly groomed. (2.4) 3.3.6 Facial hair is not allowed.

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3.4 Standards for P.E. 3.4.1 Boys: Jeans, T-shirts, and tank tops are to be worn. Shorts must be no shorter than mid-thigh.

Gym shoes must be worn. (2.2, 2.3) 3.4.2 Girls: Jeans, modest tops and shorts not shorter than mid-thigh are to be worn. Gym shoes must

be worn. (2.2, 2.3)

3.5 Please note: If your student is not appropriately dressed for school, parents will be contacted and asked to bring appropriate clothing to the school for the student.

3.6 Student visitors need to be in dress code when they come to our campus.

I agree to uphold the by the Dress Code Policy. ________ (Parent Initial)

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ENROLLMENT AGREEMENT PROVISIONS In this enrollment agreement between Umpqua Valley Christian School and the parents or guardians of the student(s) listed herein, we hereby enroll this or these students for the academic year stated with the following agreements and understanding. 1. We understand that Umpqua Valley Christian School is a ministry for the kingdom of God. As such, God’s Word, as

found in the Old and New Testaments, is the governing authority of Umpqua Valley Christian School. 2. We understand that as an integral part of the Christian Education program of Umpqua Valley Christian School, the

teachers will teach my child according to the philosophy and mission of Umpqua Valley Christian School. This teaching, which will take place in classes and chapel, will attempt to convince each student that what Umpqua Valley Christian School believes about God, the Bible, and mankind is the correct and necessary belief for every person.

3. We understand that attending Umpqua Valley Christian School is a privilege, not a right. Accordingly, my child may be disciplined, up to and including suspension or dismissal from Umpqua Valley Christian School for just cause, as determined at the sole discretion of the Administration and/or School Board of Umpqua Valley Christian School.

4. We understand that consistent with Umpqua Valley Christian School’s philosophy and mission statement, Umpqua Valley Christian School’s goal is to provide every student a Christ-centered education. However, it is primarily our responsibility to educate our child. Accordingly, we agree to require our child to perform all duties and responsibilities given to him/her by his/her instructors.

5. We understand and agree that this enrollment agreement is the sole agreement between ourselves and Umpqua Valley Christian School. Accordingly, if any provision is later found to be void or voidable, such will not affect the validity of any other provision, and that both parties agree to remain bound by all provisions.

6. We understand and agree that any and all terms used in this enrollment agreement and all other Umpqua Valley Christian School’s documents are to be applied as interpreted solely by the governing authority of Umpqua Valley Christian School. Accordingly, any disagreement as to the meaning or application of any term contained in this enrollment agreement or other Umpqua Valley Christian School’s documents is to be resolved in favor of Umpqua Valley Christian School.

7. We pledge our fullest cooperation to keep doctrinal controversy and denominationalism out of Umpqua Valley Christian School at all times.

8. Should there be a question about or disagreement with Umpqua Valley Christian School’s policies or procedures, we will in no case complain to any parent, but in the love of Christ, and with prayer will register only necessary complaints with the teacher, principal, administrator, or School Board, in that order, as appropriate. If we reach a point of disagreement on an issue of a non-criminal nature with Umpqua Valley Christian School, in keeping with I Corinthians 6:1, we agree to accept the decision of the School Board as final, rather than taking the dispute to a civil court; we waive any right to non-criminal litigation.

9. We understand that assessments will be made to cover damage of Umpqua Valley Christian School’s property (including breakage of windows, abuse or loss of books, etc.)

10. We understand that, in the event of early withdrawal during any month, tuition is payable for the entire month. 11. We agree to and accept the policy of Umpqua Valley Christian School that no grades or transcripts will be released

unless a student’s financial account is current, and waive any rights we may have in this regard under any state education code or law, with respect to ourselves and/or the child.

12. We understand and agree that should any collection of fees be necessary, we will be responsible for the cost of collections.

13. We understand and agree that this enrollment agreement does not bind either party to a specific period of enrollment; either party may terminate this enrollment agreement with written notice.

I agree with the Enrollment Agreement Provisions. ________ (Parent Initial)

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Revised February 2016

2016-2017 IN STATE TUITION AND FEE CHART

Grade

Enrollment Fee

Curriculum Fee

Tuition 1st Student 2nd Student 3rd Student 4th +Students

5day, 1/2day

Preschool $300 $250 2875.00 2590.00 2350.00 2115.00

5day Preschool/K $300 $250 4130.00 3720.00 3350.00 3015.00

1st - 6th $300 $500 4650.00 4185.00 3770.00 3390.00

7th - 8th $300 $500 4905.00 4415.00 3975.00 3580.00

9th - 12th $300 $500 5160.00 4645.00 4185.00 3770.00 ENROLLMENT FEES ARE NON-REFUNDABLE & NON-TRANSFERABLE AND DUE AT TIME OF ENROLLMENT CURRICULUM FEES ARE NON-REFUNDABLE & NON-TRANSFERABLE.

Reenrollment Discount: UVC students will pay the reduced fee of $200.00 if they register for the following

school year on or before April 1. Re-enrollment after April 1st will be $300.00. Assessment Fee: All new students will be diagnostically assessed to determine grade level placement. The

cost for testing is $25 for Preschool and Kindergarten, and $50 for grades 1-12. Testing fee is paid prior to administration of assessment.

Tuition Discount: A 2.5% discount is given on tuition only if paid in full with cash or check before September 1. We apologize for the inconvenience, but we cannot offer the 2.5% discount using credit cards.

Credit Card Payment: We accept VISA, MasterCard, AMERICAN EXPRESS, and DISCOVER, however, a 2.5% surcharge fee will be added to your credit card payment.

Sports Fees: Junior High Senior High Soccer ----- 250.00 Volleyball 175.00 250.00 Basketball 175.00 250.00 Baseball ----- 250.00 Track 175.00 250.00

PSAT Testing Fee for all 10th and 11th graders - $15.00 Bus Fees: K-12 - $80/child/month OR Daily - $ 5.00

As bus service is available, bus fees are subject to change on a quarterly basis depending on costs and bus availability.

Late Fees: A $25.00 late fee will be charged to your account if payment is not received by the 10th of the month.

NSF Fees: A $30.00 fee will be charged to your account if your check is returned by your bank. Tuition Increase: Beginning 2016-2017, there will be an automatic tuition increase of at least 1% (no more

than CPI + 2%) Payment Plans:

o 10 month payment plan available (Aug 1-May 1) o 12 month payment plan available (June 1-May 1) o Custom Payment plan available (Arrangements must be made in writing with finance

director at the time of enrollment.)

I agree to pay applicable fees within the tuition and fee chart. ________ (Parent Initial)

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TUITION PAYMENT PLAN OPTIONS

Option #1 Payment In Full: Due by September 1st (cash or check - 2.5% Discount ) Option #2 Ten month: Tuition is due on the first of each month, late after the 10th (August thru May) Option #3 Twelve month: Tuition is due on the first of each month, late after the 10th (June thru May) Option #4 Custom payment plan: Arrangements must be made in writing with Finance Director at the time of

enrollment.

Check here if applicable: I am a full time Pastor currently on staff at a local church in Douglas County (501c3) and qualify for the UVC Pastoral Discount which includes ½ tuition for all my children enrolled at UVC. Subject to verification by Administration.

Please indicate your choice of payment plan: I agree to pay my total tuition in full by September 1st. (Option #1) I agree to pay my tuition on a ten-month plan. Aug. – May (Option #2) I agree to pay my tuition on a twelve-month plan. June - May (Option #3) I agree to pay my tuition according to the defined custom plan. (Option #4)

TERMS • We understand that in the event of early withdrawal during any month, tuition is payable for the entire month and that

curriculum fees are nonrefundable.• Should my student ride the bus for 10 days in a month, I will be charged the full monthly fee in addition to the daily fee

for the first 10 days.• I understand that UVC reserves the right to withhold student academic transcripts and/or diploma in the event that I fail

to pay for services rendered as outlined in this signed Tuition Payment Plan form.• If I should fail to pay for the educational services received, I shall pay in full any attorney fees or collection agency fees

required to collect monies due UVC.• I agree to pay a $30.00 charge to my account in the event that a check is returned for non-sufficient funds.• I understand that I must attend the Freshman/Senior Orientation session with my freshman/senior child in order for my

registration to be complete.• A $25 late fee charge will be assessed to my account in the event that monthly payment is not received by the 10th of

the month.• Umpqua Valley Christian School admits students of any race, color, or national or ethnic origin to all the rights,

privileges, programs, and activities generally accorded or made available to any students of Umpqua Valley ChristianSchool. Umpqua Valley Christian School does not discriminate on the basis of race, color, or national and ethnicorigin in administration of its educational policies, recruiting, hiring, reviewing and promoting of staff, admissionspolicies, scholarships, loan programs, athletic, and other school-administered policies.

The names and grades of my child/children who will be entering UVCS are as follows:

Name:______________________________________________ Grade:_____________________

Name:______________________________________________ Grade:_____________________

Name:______________________________________________ Grade:_____________________

Name:______________________________________________ Grade:_____________________

Email address to which statements will be sent: ___________________________________________________

I agree to pay applicable fees according to the selected Tuition Plan Option and Terms. ________ (Parent Initial)

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Revised February 2016

FAMILY AND STUDENT PROFILE (Please fill out one student profile per child)

Student Last Name: Student First Name: Middle Name: Birthdate:

Parent/ Legal Guardian Last Name: Father’s First Name: __________________ Mother’s First Name:__________________

Home Phone : Grade:

Student email address: __________________________________________

Father email address: ___________________________________________

Mother email address: ___________________________________________

Legal Guardian email address:____________________________________

Student Cell Phone:_________________________

Father Cell Phone: _________________________

Mother Cell Phone: _________________________

Legal Guardian Cell Phone:__________________

Gender: M

F

Home Address: City: Zip:

Mailing Address: City: Zip:

Father’s Work Phone: Mother’s Work Phone:

Place of Employment: Place of Employment:

Family Home Church: Pastor:

Learning Disabilities and Other Special Accommodations – Has your child ever been testedand or diagnosed for a learning disability? Yes No If yes, check below

ADD ADHD Autism Asperger’s Syndrome Math Calculation Oral ExpressionBasic Reading Skills Reading Comprehension Reading Fluency Writing Ability Written ExpressionListening Comprehension other______________________________

Has your child ever been on a formal Individual Education Plan? Yes No If so, please provide paperwork.

Does your child need any other special accommodations? Yes No If yes, please explain. ________________________________________________________________________________________________

Emergency/Allergy Information - In the event of a serious accident or illness, the school will make everyeffort to contact you. If we cannot contact you, the person listed below will be contacted. In the event we cannot contact you or the emergency person, your initials below will authorize Umpqua Valley Christian Schools to call a physician or take your child to a hospital.

NAME:_____________________________PHONE:____________________RELATIONSHIP:_____________________

PHYSICIAN:____________________________________________________PHONE:___________________________

PARENTS INSURANCE CO.:______________________________________POLICY#:__________________________

INSURED NAME:________________________________________________GROUP #:_________________________

Does your child have allergies/ Yes No If so, Please list below:________________________________________________________________________________________________

I hereby state that all information in the Family and Student Profile is accurate to the best of my knowledge. ________ (Parent Initial)

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Revised February 2016

NON-PRESCRIPTION MEDICATION WAIVER I hereby permit that my child may receive non-prescription acetaminophen and ibuprofen medication as indicated

on the container. ______ (Parent Initial)

GENERIC EXCURSIONS

My child may be taken on field trips or excursions by bus, private motor vehicle; and on neighborhood walking excursions, under required supervision.

______ (Parent Initial) STUDENT PICK-UP AUTHORIZATION (Who is and is NOT allowed to pick up your child?)

A. Name _______________________Phone # __________________ Relationship _________________ B. Name _______________________Phone # __________________ Relationship _________________ C. Name _______________________Phone # __________________ Relationship _________________ D. Name _______________________Phone # __________________ Relationship _________________ Please list individuals NOT ALLOWED to pick up your child.

E. Name _______________________Phone # __________________ Relationship _________________ F. Name _______________________Phone # __________________ Relationship _________________ I hereby permit that my child may be picked up ONLY by those listed in the Pick-Up Authorization section and

confirm that those listed in the Not Allowed Section are not allowed to pick up my child. ______ (Parent Initial)

PHOTO AND QUOTATION RELEASE I hereby authorize and give full consent to Umpqua Valley Christian School to publish and copyright all photographs and quotations in which my child appears while enrolled as a student in any and all programs of Umpqua Valley Christian School. I further agree that Umpqua Valley Christian School may transfer or use these photographs or quotations in school brochures, newsletters, advertising, posters, displays, slide shows, videotapes, catalogs, CD-ROMS, and like publications, literature, or materials without limitations or reservations. Additionally, I agree that the use of a photograph or quotations does not constitute in any manner a waiver of Umpqua Valley Christian School’s policies, program, or rules, nor does continued use constitute an agreement to continue the child’s enrollment.

I hereby approve the foregoing and consent to the use of photographs or quotations subject to the terms mentioned above. I affirm that I have the legal right to issue such consent.

______ (Parent Initial)

SCHOOL DIRECTORY RELEASE

I hereby authorize and give full consent to Umpqua Valley Christian School to publish our family’s information in

the school directory. Information may include names (parents and child/children), address, phone number and email address(s).

______ (Parent Initial)

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Revised February 2016

JUNIOR AND SENIOR HIGH SCHOOL STUDENT STATEMENT OF COOPERATION (Students entering 7th-12th Grade) I have read the Mission Statement, Belief Statements, Enrollment Agreement Provisions, and the Computer Acceptable Use Policy sections of the Umpqua Valley Christian School Enrollment Packet.

I understand that these documents were written with my best interest in mind, to help me fulfill my God-given responsibility to be obedient to the human authorities placed in my life by God.

I understand that I may attend Umpqua Valley Christian School only so long as I demonstrate behavior and attitude consistent with these statements.

I understand that by signing this Statement of Cooperation, I am agreeing to a) abide by the Standards of Conduct and Dress Code of; b) obey each faculty member promptly and with a good attitude; c) respond with a teachable attitude when corrected; and d) offer my best effort in all school work.

I agree with and agree to abide by all statements contained within the Junior and Senior High School Student Statement of Cooperation.

_____ (Student Initial)

PARENT STATEMENT OF COOPERATION We have read the Mission Statement, Belief Statements, Enrollment Agreement Provisions, and the Computer Acceptable Use Policy sections of the Umpqua Valley Christian School Enrollment Packet.

We understand that these documents were written with my child’s best interest in mind, to help us fulfill our God-given responsibility to be obedient to the human authorities placed in his or her life by God.

We understand that our child may attend Umpqua Valley Christian School only so long as he/she demonstrates behavior and attitude consistent with these statements.

We understand that by signing this Statement of Cooperation, we are agreeing to lovingly but firmly require that our child a) abide by the Standards of Conduct and Dress Code; b) obey each faculty member promptly and with a good attitude; c)respond with a teachable attitude when corrected; and d) offer his/her best effort in all school work.

We hereby invest authority in Umpqua Valley Christian School to discipline our child as described in the school handbook. We further agree that we will cooperate and discipline our child in the home as needed.

We agree with and agree to abide by the Parent Statement of Cooperation. ______ (Parent Initial)

SIGNATURESWe acknowledge that by signing we have read, initialed, and agree to abide by all sections contained herein. Any sections not initialed indicate a disagreement with the statements and may be considered when determining (re) enrollment eligibility.

___________________________________________________________ ____/____/____ Student Signature Date ___________________________________________________________ Student Printed Name

___________________________________________________________ ____/____/____ Parent / Legal Guardian Signature Date __________________________________________________________ Parent / Legal Guardian Printed Name

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UVC Forms 2/06

Umpqua Valley Christian Schools PREVIOUS SCHOOL REFERENCE FORM

To the Applicant’s Parents: Please complete the upper portion of this form, including Parent Authorization for Release of Recommendation and Records; then give this form to a principal, counselor, or teacher from the applicant’s current school, with an enclosed self-addressed envelope. (This form must be returned promptly to Umpqua Valley Christian School in order to avoid delaying your child’s enrollment. Thank you!)

Grade Entering________

Student Name: ________________________________________________________ ______________________ Last First Middle Date

Parent/Guardian Name:__________________________________________________ ( )_________________ Last First Middle Phone #

Parental Authorization for Release of Recommendation and Records Authorization is hereby granted to the person completing this form to release any information and/or records he or she deems appropriate to Umpqua Valley Christian School regarding the enrollment of my child. I understand Umpqua Valley Christian School will hold this information in strictest confidence, using it only for the purpose of evaluating my child with regard to enrollment in Umpqua Valley Christian School. Parent/Guardian’s Signature:________________________________________ Date:___________________

To Principal, Counselor, or Teacher: The above-named student has applied for enrollment in Umpqua Valley Christian School. Please complete this form to the best of your knowledge, providing information that will help us evaluate this student as a candidate for admission. This information will remain strictly confidential.

How many years has this applicant been enrolled in your school? _____________

STUDENT RATING Excellent Good Fair Poor Unknown Comments Attendance/Punctuality Academic Rank (Top 10%) (Top 25%) (Top 50%) (Bottom

50%)

Behavior/Conduct Work/Study habits Response to authority Personal appearance Influence on peers Parental cooperation

Additional comments, especially explaining any “poor” ratings: ______________________________________________ ____________________________________________________________________________________________________________________________________________________________________________________________________

RECOMMENDATION: I recommend this student ____ Strongly _____ Simply _____ With Reservations _____ Not at all

Additional comments: _______________________________________________________________________________ ____________________________________________________________________________________________________________________________________________________________________________________________________

_______________________________________ _____________________ ____________________ Signature and Title Date Phone Number

Thank you for your assistance!

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Pre-School ~ Kindergarten ~ Primary School ~ Junior High ~ High School

Umpqua Valley Christian School REQUEST FOR STUDENT RECORDS

“Partnering with Parents to Educate and Disciple Students from a Biblical Worldview.”

The following student has enrolled in Umpqua Valley Christian School. Please forward, at your earliest convenience, all records and information you have for this student. Student Information Students Name Date of Request

Grade Entering Date of Birth

Signature of Parent, Legal Guardian or Student Over 18 Years of Age

Records Requested From School Name: School Address: Registrars Signature: Date:

18585 Dixonville Road, Roseburg, OR 97470; Phone (541) 679-4964; Fax (541) 679-1881

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UVC Forms 2/06

Umpqua Valley Christian Schools PERSONAL REFERENCE FORM

To the Applicant’s Parents: Please complete the upper portion of this form, including Parent Authorization for Release of Recommendation then give this form to a friend, with an enclosed self-addressed envelope. (This form must be returned promptly to Umpqua Valley Christian School in order to avoid delaying your child’s enrollment. Thank you!) Grade Entering __________ Student ___________________________________________________________ _______________ First Middle Last Date Parent/Guardian ____________________________________________________ (____)__________ First Middle Last Phone Parental Authorization for Release of Recommendation Authorization is hereby granted to the person completing this form to release any information he or she deems appropriate to Umpqua Valley Christian School regarding the enrollment of my child. I understand Umpqua Valley Christian School will hold this information in strictest confidence, using it only for the purpose of evaluating my child with regard to enrollment to Umpqua Valley Christian School. Parent/Guardian Signature: __________________________________________________________________ To adult family friend who has had personal contact with the student: The above-named student has applied for enrollment in Umpqua Valley Christian School. Please complete this form to the best of your knowledge, providing information that will help us evaluate this student as a candidate for admission. This information will remain strictly confidential.

STUDENT RATING Excellent Good Fair Poor Unknown Comments Leadership ability Spiritual/Devotional life Behavior/Conduct Church involvement Relationship to Parents Personal appearance Influence on peers Christian testimony Additional comments, especially explaining and “poor” ratings:___________________________________________ ________________________________________________________________________________________________________________________________________________________________________________________________________________________ RECOMMENDATION: I recommend this student ____ strongly ____ simply _____ with reservations _____ not at all Additional Comments: _______________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ _______________________________________ _____________________________________________ _____________ Signature Relationship to Student Date (_____)_____________________ Phone Number Thank you for your assistance!

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UVC Forms 2/06

Umpqua Valley Christian Schools CHURCH REFERENCE FORM

To the Applicant’s Parents: Please complete the upper portion of this form, including Parent Authorization for Release of Recommendation then give this form to the applicant’s Pastor, Youth Pastor, or Sunday School teacher, with an enclosed self-addressed envelope. (This form must be returned promptly to Umpqua Valley Christian School in order to avoid delaying your child’s enrollment. Thank you!)

Grade Entering_______

Student ___________________________________________________________ __________________ First Middle Last Date

Parent/Guardian ____________________________________________________ (____) ____________ First Middle Last Phone

Parental Authorization for Release of Recommendation Authorization is hereby granted to the person completing this form to release any information he or she deems appropriate to Umpqua Valley Christian School regarding the enrollment of my child. I understand Umpqua Valley Christian School will hold this information in strictest confidence, using it only for the purpose of evaluating my child with regard to enrollment to Umpqua Valley Christian School.

Parent/Guardian Signature:____________________________________________________________________

To Pastor, Youth Pastor, or other Church Worker: The above-named student has applied for enrollment in Umpqua Valley Christian School. Please complete this form to the best of your knowledge, providing information that will help us evaluate this student as a candidate for admission. This information will remain strictly confidential.

STUDENT RATING Excellent Good Fair Poor Unknown Comments Leadership ability Spiritual/Devotional life Behavior/Conduct Church involvement Relationship to Parents Personal appearance Influence on peers Christian testimony

Additional comments, especially explaining and “poor” ratings: __________________________________________ ________________________________________________________________________________________________________________________________________________________________________________________________________________________

RECOMMENDATION: I recommend this student ____ strongly ____ simply _____ with reservations _____ not at all

Additional Comments: _______________________________________________________________________________ ____________________________________________________________________________________________________________________________________________________________________________________________________

______________________________________ ______________________________________ ____________________ Signature Title Date (_____)_____________________ Phone Number

Thank you for your assistance!

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To be completed by all students entering grades 7-12

UVC Forms 04-05 (January, 2005)

Umpqua Valley Christian School NNEEWW SSTTUUDDEENNTT IINNFFOORRMMAATTIIOONN

PLEASE PRINT CLEARLY AND NEATLY IN YOUR OWN HANDWRITING

PERSONAL INFORMATION Your full name: _____________________________ Your age:________ Your last completed grade: _______ Your parents’ or legal guardians’ full names: ____________________________________________________

PREVIOUS SCHOOL GENERAL INFORMATION Last school attended: __________________________________________ Grades attended:_____________ Why did you leave this school? _______________________________________________________________

PREVIOUS SCHOOL ACADEMICS/BEHAVIOR/LEADERSHIP ACADEMICS

*PLEASE ATTACH A COPY OF YOUR MOST RECENT QUARTER OR SEMESTER REPORT CARD

On a sheet of paper, please write a detailed explanation for each grade of “D” or “F” on your report card.

What is your favorite subject?____________________ What subject is most difficult for you? ____________ Have you ever repeated a grade?_______ If yes, what grade did you repeat?__________________________

ATTENDANCE – PUNCTUALITY How many times were you tardy to class during your last quarter?_____ How many times absent?_________

HOMEWORK In your academic classes (English, Math, Science, History), how many times per week (average) were you assigned homework? ______ How many times (average) did you complete your homework on time? ______

BEHAVIOR – EFFORT On a scale of 1-10, please rate your effort in class and your behavior at school for the last school you attended (10 is the maximum effort and excellent behavior; 1 is little or no effort and unacceptable behavior – circle the appropriate number.) Effort in class: 1 2 3 4 5 6 7 8 9 10 Behavior at school: 1 2 3 4 5 6 7 8 9 10

LEADERSHIP – ACTIVITIES Please list any leadership positions you held at your last school (Student council, Rally committee, etc.), any school clubs, organizations, or sports teams in which you were actively involved (Spanish Club, Soccer, etc.)

DISCIPLINE Have you been suspended any time during the last two years of school? Y N If yes, on a separate sheet of paper, please write a detailed explanation for each suspension.

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To be completed by all students entering grades 7-12

UVC Forms 04-05 (January, 2005)

YOUR CHOICE IN EDUCATION How did you find out about Umpqua Valley Christian School? ______________________________________ What do you know about UVCS?______________________________________________________________ How do you feel about the decision for you to attend UVCS? _______________________________________ If it is your choice to attend UVCS, please list below the reasons why you want to enroll here.

SPIRITUAL INTEREST Do you believe in God? _____________ What do you know about or believe about the Bible? _____________________________________________

What is your religious affiliation? (Christian, other)______________________________________________

On a scale of 1-10, please rate your practice of your religious faith (10 means you are very devout in your faith; 1 means you are not really involved at all. Please circle the appropriate number.):

1 2 3 4 5 6 7 8 9 10

PLEASE ANSWER THESE QUESTIONS IF YOU INDICATED ABOVE THAT YOU ARE A CHRISTIAN Who is Jesus Christ? _______________________________ What church do you attend? ________________ How often do you attend? _______________ Do you attend with your family or by yourself? ____________ Are either of your parents Christians? ___________ How often each week do you read the Bible on your own, outside of church or school? __________ How often each week do you pray to God by yourself? ____ In what ministries or Christian activities are you involved on a regular basis? _________________________ _________________________________________________________________________________________

On a separate sheet of paper, please write out your Christian testimony (in your own handwriting). Your testimony should include: 1) How you came to be a Christian; 2) What it means to be a Christian; 3) How your life has changed specifically since you became a Christian; 4) What your goals are for your Christian walk with God. How would you want UVCS to help you grow in your relationship with God? __________________________________________________________________________________________

YOUR GOALS/ADDITIONAL INFORMATION What are your academic goals? ______________________________________________________________ Do you plan to attend college? ________ If yes, what college to you plan to attend? __________________ What are your life/career goals? ______________________________________________________________ Please list any other information you would like to provide as we consider your application for admission to UVCS.____________________________________________________________________________________ Do you plan on applying to another school for the next school year? Yes No

I have attended Freshman Orientation Yes No August _________

For office Use Only

Date Returned: ____________________ Interviewed by: ______________________________________

Comments: ________________________________________________________________