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Request Information

  • Inquiry/Applicant process:  filling out the information does not obligate you to enrolling. 
    • At this time this process provides me your email to notify you of possible scholarships or other information you may want.
    • We will NOT use this information to contact you about pursuing enrollment.  I will provide you only with the information you ask for.
    • If and when you decide to enroll the information you provide will be used as the Student's Application. You may contact me at apellegrin@hbcsni.org  
    • You may update all information at the time of completing the application process. 
  • Applications are processed when meeting with an Admin. on a first come, first served basis.  Application Fee is non-refundable.
  • Enrollment stays open all school year as long as we have availability in the grade level. 
Registration for 21-22 begins: 
Monday 11/16/2020  -  current HBCS student and PK3/PK4
Monday  1/11/2021   -  siblings of re-enrolled HBCS students, Church Members, CLC
Monday  2/8/2021    -  Community

Please view the Student Handbook on our website for all Policy & Procedures...

 

HBCS does not discriminate on the basis of race, color, national or ethnic origin.   IRS Revenue Procedure 75-5 requires schools to keep records on the racial composition of its student body, faculty, and administrative staff for each academic year.

* Indicates a required field.

Parent / Guardian Information
  • First Parent / Guardian
  • Last Name *
  • First Name *
  • Email Address *
  • Gender
    Male    Female
  • Work Phone
    (Ex: 999-999-9999)
  • Cell Phone
    (Ex: 999-999-9999)
Home Address
  • Street Address *
  • City *
  • Country *
  • State *
  • Zip *
  • Home Phone *
    (Ex: 999-999-9999)
  • I want to: 

    *
  • I would like my child to begin:

    *
  • Mailing address if different than street address...

    *
  • Student resides with:

    *
  • If parent/guardian is divorced/separated who is the domicile parent?  Please provide school with legal documentation.

    *
  • Name of person financially responsible?

    *
  • Person Financially Responsible Email

    *
  • Financial Responsible Address:

    *
  • Person Financially Responsible Phone number

    *
  • Is the Financial Responsible Person a Highland Baptist Church Member?  An active, participating member of Highland Baptist Church is one who has all of the following:
    •  made a profession of faith and/or come by statement
    • transferred membership from previous church
    •  taken the New Members Class (2 sessions)
    •  has been baptized if not previously baptized in another Baptist church
    •  attends weekly worship services on a consistent basis        
    * Yes   No
  • How will Tuition and Fees be paid via FACTS?       

    *
  • Are you or any person that may come to school for the student required to provide sex offender notification pursuant to the law?  Yes/No If yes, name of offender and Relationship to Student..

    *
  • Would you like to schedule a Parent tour of the campus with myself and/or meeting with Administration? Indicate possible Date & time?

    *
  • Below you will check yes or no and have a eSignature in Agreement to the following:

    • Parent/Student Contract
    • Records Release
    • Policy and Procedure Acknowledgement
    • Medical Release
     
     
    Parent / HBCS Contract
    This contract is entered into by and between Highland Baptist Christian School (HBCS) and the parents(s) listed and/or guardian(s) of student applied for.
    It is understood that upon our child’s acceptance at HBCS, we are responsible for timely payment of all fees and tuition.  Application Fee, Student Fee, and Operational Maintenance Fee are non-refundable. 
    Monthly payments are due by the 1st, 5th, 10th of each month; payments become delinquent after the 10th of each month with a late fee of $25.00 accrued.  If tuition or any other fee is not paid by the 15th of the month by 9 a.m., my child will not be permitted to attend HBCS and may return only after fees are paid. The student will receive a zero for any assignments or tests missed.  
    Refund Policy
    • A full refund of pre-paid annual tuition will be made if a student transfers out before school begins.  
    • Half of pre-paid annual tuition will be refunded if a student transfers before the start of the spring semester.  
    • No refund for pre-paid annual tuition will be given if a student transfers after the spring semester begins.  
    • If a student who pays monthly transfers from HBCS during the school year, the responsible party listed above is obligated to pay the balance of the remaining monthly payments for that semester.  
    • Student records will be held until balance on account is paid in full.  
    • Student fees as well as application fees are non-refundable for any reason. 
    NSF Policy
    • Non-sufficient funds (NSF) checks are charged a $30.00 fee. 
    • Parent must log onto their FACTS account to make a payment. If this fee is not paid within 5 business days, the student will not be permitted to attend HBCS and may return only after fees are paid.
    • The student may receive a zero for any assignments or tests missed.
    • HBCS reserves the right of collection, including forwarding the check to the D.A.’s office for collection. 
    • In the event that more than two NSF checks received from the same family in a school year, all subsequent payments must be made in cash or money order.
    • Both parties agree that in the event of the necessity to institute legal proceedings to enforce any terms of this contract, the prevailing party shall be entitled to be reimbursed for all reasonable attorney’s fees and costs incurred, as well as court costs.                                                                                                                            
    I give permission to request records from prior school(s) and/or learning centers my child has attended. 
     
    Student Application/Policies: I hereby acknowledge that I have reviewed and agree to comply with: Admission Policy, Statement of Academic Responsibility, Code of Honorable Conduct, Acceptable Use Policy for Internet, Policy/Procedures for Drug Screening(Gr. 7th-12th), Chromebook Policy(Gr. 7th-12th).  These Policies/Procedures can be found in the Parent/Student Handbook at www.hbcsni.org.  You may contact the school as well to be emailed a copy.
     
     
    Permission to Medically Treat Student: If your child is seriously injured and school personnel are unable to reach an emergency contact, the final decision for action taken will be the judgment of school authorities. The parents/guardians give their authority to school personnel to take such action in treating their son/daughter. This includes transporting an injured or very ill child to the emergency room of a local hospital if so deemed.  


    HBCS does not discriminate on the basis of race, color, national or ethnic origin. IRS Revenue Procedure 75-5 requires schools to keep records on the racial composition of its student body, faculty, and administrative staff for each academic year.

    Do you agree to the above?

    * Yes   No
  • Parent eSignature:

    *
  • Date:

    * (mm/dd/yyyy)
  •  
  • Student 1
  • First Name *
    Middle Name *
    Last Name *
  • Birthdate *
    (mm/dd/yyyy)
    Gender *
    Male    Female
  • Grade Level of Interest *
    School Year *
  • Current School
  • Does the student want to "shadow" their current grade?    Shadow: to spend a half day or whole day with the students/teacher of their current grade level.

    * Yes   No
  • Current Grade Level

    *
  • Does student use Resources such as 504, IEP and/or etc?  If yes, please explain...

    *
  • Has student ever been suspended or expelled? Explain if yes...

    *
  • Ethinicity: 

    *
  • Race:

    *
  • Name of the public school the student is zoned for in your parish?

    *
  • School currently attending

    *
  • ***  Photos of students may appear in school publications such as Highland Highlights, The Growl yearbook, and/or school’s website.  At times, The Daily Iberian or other media outlets may run photos of our students in sporting events or other school-related activities.  Do you give permission for HBCS to use photo(s) of my son/daughter?

    * Yes   No
  • MEDICAL INFORMATION

    Physician Name and Number:

  • Dentist Name and Number: 

  • Hospital:

  • Does the student have a medical condition or chronic illnesses?

  • Is the student allergic to insect bites, bee stings or ant bites?

  • List any other known allergies:

  • Seasonal Allergies? Describe?

  • Does the student have: Diabetes? Asthma? Epilepsy? and explain

  • Does the student have any condition which may require frequent restroom breaks? explain...

  • Does the student have a medical diagnosis that may affect learning? ADD, ADHD, Dyslexia - explain

  • Has the student been diagnosed with a hearing impairment and/or chronic ear infections/tubes? Describe:

  • Does the student have a visual impairment or wear glasses or contacts? Describe:

  • Has medication been prescribed for the student to take throughout the year? Describe:

  • FAMILY INFORMATION:

    If multiple families : Please give Name of other parent in "Family 1"....

  • Relationship to student:

  • Contact Cell Number:

  • Contact Home Number and/or Work number - indicate next to each number

  • Would Parent like to receive weekly school announcements via email? 

    Yes   No
  • Email address:

  • If applicable Is there a Family 2?

    Yes   No
  • If yes, what is Family 2's address?

  • If applicable what is the Name of Parent 1 in Family 2

  • Relationship to student:

  • Contact Cell Number

  • Contact Home Number and/or Work number - indicate next to each number

  • Would Parent like to receive weekly school announcements via email? 

    Yes   No
  • Email Address:

  • If applicable what is the Name of Parent 2 in Family 2

  • Relationship to Student:

  • Contact Home Number and/or Work number - indicate next to each number

  • Contact Home Number and/or Work number - indicate next to each number

  • Would Parent like to receive weekly school announcements via email? 

    Yes   No
  • Email address:

  • If submitting application for more than 1 student...

    Use the same Family 1 information provided above.

    Yes   No
  • If submitting application for more than 1 student...

    Use the same Family 2 Information as provided above.  If different Family 2 fill out info. in that student profile questions.

    Yes   No
  • List Emergency Contact or Pickup Contact People:  Name, Relationship to student and contact numbers

  • Use above emergency contact/pick up list for all students applied for.  If No, indicate persons in that students questionairre section.

    Yes   No
  •  
  • Is There Another Student?
    Yes No
  •  
  • Parent / Guardian Notes
  •