Olympic Christian Academy

Application

PO Box 27 - 117 8th Street - McCleary, Washington 98557
Telephone: 360.495.3832 - E-Mail: oca@go2occ.com


This application must be accompanied by a $10.00 application fee by paypal to _ with the same name or this application will not be processed.


Student Information - Please type or print clearly

Name: (*)

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Address: (*)

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City: (*)

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State: (*)

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Zip: (*)

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Telephone: (*)

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Parent/Guardian Email Address: (*)

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Birth Date: (*)

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Gender: (*)

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Has applicant ever been expelled from, or refused admission to another school? (*)

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Has applicant ever been in trouble with the authorities or arrested? (*)

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Has applicant ever used tobacco, drugs or alcohol? (*)

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Has applicant ever failed in school? (*)

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If you answered "yes" to any of the questions, please explain...

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Family Information

Father's Name: (*)

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Mother's Name: (*)

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Marital Status (*)

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If there are school-aged children in your home or family who will not be attending Olympic Christian Academy, please provide their names and ages.

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Religious Information

Father's Religious Affiliation: (*)

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Mother's Religious Affiliation: (*)

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Religious Institution Attended by Applicant and/or Family: (*)

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Address: (*)

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City: (*)

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State: (*)

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Zip: (*)

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Minister: (*)

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Medical Information


Does the applicant have any of the following...

Physical Disabilities (*)

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Emotional Disorders (*)

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Communicable Diseases (*)

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Allergies (*)

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If you answered "yes" to any of the medical conditions questions, please explain.

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Please provide a current copy of the applicant's immunization schedule; applicant must have all prescribed immunizations required for his or her age before entering Olympic Christian Academy.