All Forms
Back Home
Application
Please scroll down to complete the
form:
2023-2024 New Student Application
Step
1
of
8
12%
Student Information
Student(s)
*
First and Last
Grade This School Year
Grade Next School Year
Date of Birth
If you are enrolling more than one student, click the "plus sign" on the right to add additional students.
Address
*
Street Address
Address Line 2
City
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Previous School Attended
School Name
If multiple students attended other schools, please separate each school with a comma.
School Address
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Swaziland)
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Réunion
Saint Barthélemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen Islands
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Reason for leaving:
*
Student History Questions
Please indicate whether the applicant(s) has/have experienced any of the following:
Disciplinary Problems such as an office referral, suspension, expulsion, etc.?
Yes
No
Arrested/petitioned and/or placed on court ordered probation?
Yes
No
Been evaluated for special needs or recommended for, or received any special educational services?
Yes
No
For the questions you answered "yes" to above, please provide an explanation:
*
Church Information
Church Name
Pastor's Name
Church Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Swaziland)
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Réunion
Saint Barthélemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen Islands
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Statement of Cooperation and Waiver of Liability
I recognize that attendance at Lighthouse Baptist Academy is a privilege and not a right. Parents are expected to cooperate with and support the Academy and its teachers in the education and discipline of their child(ren) both in the classroom and during other school-related activities. I believe that discipline is necessary for the welfare of each student and the entire Academy. I give permission for my child’s teacher and/or other agents of the Academy to make and enforce classroom regulations in a manner consistent with Christian principles. Students shall forfeit the privilege of attending the Academy if they do not conform to the standards and way of life at the Academy. The Academy reserves the right to withdraw a student at any time that the student, in the opinion of and sole discretion of the Academy, does not conform to the spirit of the Academy. In the event that a Lighthouse Baptist Academy photographer or videographer takes a picture with my child in it, either individually or in a group, I give permission for my child’s image to be used in future brochures, videos, or other publications of Lighthouse Baptist Academy or its affiliates. I give permission for my child, whose name is set forth below, to take part in all activities, including, without limitation, transportation to and from school (including times before pick up and following discharge from the bus), gymnasium activities, bus trips, sports activities on the premises of Lighthouse Baptist Academy, and Academy-sponsored trips away from the premises. I indemnify and hold Lighthouse Baptist Academy and Lighthouse Baptist Church, its affiliates, employees, and agents harmless from and against any claims, demands, causes of action, liability, medical payments, costs, and attorneys’ fees resulting from or arising out of the participation by my child in the activities mentioned above. I understand that Lighthouse Baptist Academy and its affiliates do not provide medical insurance coverage for my child. I will be solely and entirely responsible for any medical expenses or other liabilities incurred. I understand that should any information from any enrollment forms change, I must have a corrected form signed, updated, and delivered to Lighthouse Baptist Academy. This Statement of Cooperation and Waiver of Liability shall remain in effect for as long as my child listed attends Lighthouse Baptist Academy, whether in the pre-kindergarten, kindergarten, elementary, junior-senior high, or summer school. Any reference herein to “child” shall include the student(s) listed.
Parent / Guardian Signature:
*
By typing your name below you consent to this digital form of a signature.
Parent Information
Father's Name:
*
First
Last
Father's Phone:
*
Father's Email:
*
Employer:
*
Work Phone:
*
Mother's Name:
*
First
Last
Mother's Phone:
*
Mother's Email:
*
Employer:
*
Work Phone:
*
If the parents are separated or divorced, with whom does the student live?
Parent-Student Agreement
• To be read and signed each year by all parents who have children in K3-6th grade.
• To be read and signed each year by the parents and all students 7-12th grade.
• All students are required to read the entire handbook.
As a student of Lighthouse Baptist Academy, I will:
Do my best to have personal time with God each day through Bible reading and prayer.
Do my best to regularly attend a local Bible-believing church.
Protect my mind, body, and morals from evil companions by not making them my intimate associates.
Select wisely the television programs I watch and will turn from those programs that have vulgar language or scenes of immorality, profanity, or any other activities of which Christians should disapprove.
Refrain from listening to music that is not Christian. Specifically, music which suggests turning against authority, living to enjoy self and immorality, and living for the thrill of the present without thinking of the consequences.
Refrain from the use of alcohol, drugs, or tobacco products.
Seek to faithfully witness as a Christian by looking, acting, and talking like a Christian.
If during the school year, the school administration brings to my attention something that they deem too worldly for a Christian young person, I will respectfully submit to such authority, realizing their intentions are not to be hurtful but that they have only my best intentions in mind.
Take responsibility for my education by doing my best to actively listen, pay attention, participate in class, heed deadlines, complete all homework assignments/projects, prepare for quizzes/tests, and fulfill all course requirements.
I understand the LBA Student Handbook contains the information that I will be expected to know and to abide by at Lighthouse Baptist Academy. I intend to read the entire Handbook as listed above before the beginning of the school year and will abide by the rules and the spirit of the rules contained in the Student Handbook while a student at LBA.
Application
Number of students Applying
*
Please enter a number greater than or equal to
1
.
CC Processing Fee
Price:
$0.00
Total due:
$0.00
Credit Card
*
Card Details
Cardholder Name
This completes the "student information" and "application fee" sections of your application.
Your application can be continued by filling out additional information found in our application packet.
Parent / Guardian Signature:
*
By typing your name below you consent to this digital form of a signature.
Signature
Reset signature
Signature locked. Reset to sign again