Emmanuel Academy P O Box 1504 ~ 108 Dansing Street Lake City, SC General Information Date Completed__________________ Name of Student: First ______________________Middle____________________Last________________________ Date of Birth (Month/Day/Year)________________________ Age_____ Current Grade_________ Name of Parent or Legal Guardian: First_________________________Middle________________Last_________________________ Phone: (H)____________________(W)____________________(C)________________________ Physical Address:_______________________________________________________________________ City___________________________________, South Carolina, Zip Code___________________ Mailing Address (If different from above) ____________________________________________ City___________________________________, South Carolina, Zip Code__________________ Academic History Most Recent School Attended: ______________________________________________________________________________ Reason for Transfer: ______________________________________________________________________________ Has student ever had an Individualized Education Plan (IEP)? Yes____ No_____ Was student receiving any therapy, or attending any Resource or Gifted & Talented classes? If yes, briefly describe (Name/Type of class and number of days/hours attended per week.) _______________________________________________________________________________ _______________________________________________________________________________ Student’s Special Interests, Achievement Awards or Recognition: _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ Disciplinary Action (Applies only to students who are NEW applicants seeking enrollment in EACS) During the past two school years, has student been suspended from, expelled from, or asked not to return to school? _____Yes._____No. If “Yes”, complete this section: Date of incident_____________ School where incident occurred___________________________ Reason for Disciplinary Action_________________________________________________________________________ Length of Suspension:__________ (How many days?)

EMERGENCY CONTACTS List contacts in the order you want the school to notify them in case of emergency: (Be sure to list yourself first and the phone number that is the MOST reliable way to contact you. Then list, in order of your preference, others whom we should contact if we are unable to reach you. List Parents and Legal Guardians first: 1. Name__________________________________Phone _____________________________ Other Phone #s: __________________________ _____________________________ Relationship to student _______________________________________________________ 2. Name___________________________________Phone____________________________ Other Phone #s: __________________________ ____________________________ Relationship to student______________________________________________________ 3. Name___________________________________Phone ___________________________ Other Phone #s: __________________________ ____________________________ Relationship to student______________________________________________________ 4. Name___________________________________Phone _____________________________ Other Phone #s: __________________________ ______________________________ Relationship to student________________________________________________________ Medical History (If you need more space, please attach a separate piece of paper.) Primary Physician:_________________________________Phone__________________ Office Address ________________________________________________________ Known medical conditions AND/OR allergies: _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ Prescription Medications: (List the name and dosage.) _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________

Medical Transport Authorization In the event of an emergency, I authorize Emmanuel Academy to transport my child to the nearest medical facility or hospital emergency room. _____________________________________________________ Signature of Parent/ Legal GuardianDate _____________________________________________________ Signature of Parent/Legal Guardian Date Special Instructions If there are any specific directives you want the school to follow in the event of an emergency, please list them here: _____________________________________________________________________________ Preferred Ambulance Service Which local ambulance service do you prefer to transport your child? (List in order of preference) _______________________________________ Phone _____________________________ Student Insurance Information Name of Company_______________________________Phone ______________________ Agent/Contact Person ___________________________________ Please provide the school with a copy of the insurance card.

Authorized to Pick Up or Sign Out Student NOTE: The school will not allow a student to leave with someone other than the REGULAR transporter unless the PARENT or LEGAL GUARDIAN notifies the school in writing or via phone call. We cannot receive this information from the student. It must come from the parent or legal guardian. List those who are authorized to transport your child to and from school: Driver _________________________________________ Relationship to student_________________________________________ Make & Model of Vehicle_________________________________________ Vehicle License Tag# _________________________________________ Driver _________________________________________ Relationship to student_________________________________________ Make & Model of Vehicle_________________________________________ Vehicle License Tag# _________________________________________ Driver _________________________________________ Relationship to student_________________________________________ Make & Model of Vehicle_________________________________________ Vehicle License Tag# _________________________________________ Driver _________________________________________ Relationship to student_________________________________________ Make & Model of Vehicle_________________________________________ Vehicle License Tag# _________________________________________

AUTHORIZATION TO POST STUDENT PHOTO AND WORK ONLINE  Emmanuel Academy wants to celebrate students and their academic accomplishments. By signing below you authorize Emmanuel Academy to post pictures of your child(ren) and to showcase their academic work and projects, including short video clips. Check the appropriate response and then sign as indicated: ____ I grant my permission for online postings. ____ I do not agree for online postings. _______________________________________ Parent/Guardian SignatureDate

Request for Transfer of Records Emmanuel Academy P O Box 1504 ~ 108 Dansing Street Lake City, SC Ph: Fax: Date:_____________________________ To:___________________________________________________ From:_________________________________________________ RE: Student______________________ DOB:_________________ To Whom It May Concern: Please transfer all school records for my child, ____________________________, to Emmanuel Academy, 108 Dansing Street, Lake City, SC If you should have any questions, please contact the school director, Ms. Marcia M. Ramsey, at Thank you, _______________________________________ Parent/Guardian SignatureDate

REGISTRATION & TUITION For 5 Year Kindergarten Registration Fee – Due at time of registration – NON-REFUNDABLE $ Annual Tuition…………………$ Tuition Payments begin on June 5, Pay in 12 monthly payments of $234.00* *The final two payments are $ each Emmanuel Academy P O Box 1504 ~ 108 Dansing Street Lake City, SC ENROLLMENT CONTRACT FOR ONE K-5 STUDENT Terms of Agreement I have read this agreement and understand that it is my obligation to pay the fees for educational services rendered to my child(ren) for the academic year stated above. I further understand that in signing this agreement, I am accepting the policies and procedures of Emmanuel Academy on behalf of my child(ren). I understand that if I choose the Budget Payment Plan, 12 monthly payments are due by the 5 th day of each month beginning in June __________ and continuing through May of __________. I am aware that a late fee of $20.00 will be added to my account for any payments that are more than 7 calendar days late. ______(initial) I also understand that if my account becomes 45 calendar days past due, it may result in a dismissal of my child(ren) unless the past due amount is brought current.______(initial) I further understand that if my child(ren) is withdrawn from school for reasons unrelated to a medical condition as stated in a physician’s letter, the remainder of the year’s tuition is still due and payable. Emmanuel Academy reserves the right to address this type of issue on a case by case basis. ______(initial) Signature _____________________________________ Date___________________

REGISTRATION & TUITION Registration Fee – Due at time of registration – NON-REFUNDABLE $ Annual Tuition…………………$ Materials fee…………………..$ to be paid by July 15, 2014 Tuition Payments begin on June 5, Pay in 12 monthly payments of $ Emmanuel Academy P O Box 1504 ~ 108 Dansing Street Lake City, SC ENROLLMENT CONTRACT FOR ONE STUDENT Terms of Agreement I have read this agreement and understand that it is my obligation to pay the fees for educational services rendered to my child(ren) for the academic year stated above. I further understand that in signing this agreement, I am accepting the policies and procedures of Emmanuel Academy on behalf of my child(ren). I understand that if I choose the Budget Payment Plan, 12 monthly payments are due by the 5 th day of each month beginning in June _2014__ and continuing through May of __2015__. I am aware that a late fee of $20.00 will be added to my account for any payments that are more than 7 calendar days late. _______ (initial) I also understand that if my account becomes 45 calendar days past due, it may result in a dismissal of my child(ren) unless the past due amount is brought current. ______(initial) I further understand that if my child(ren) is withdrawn from school for reasons unrelated to a medical condition as stated in a physician’s letter, the remainder of the year’s tuition is still due and payable. Emmanuel Academy reserves the right to address this type of issue on a case by case basis. _______(initial) Signature _____________________________________ Date___________________

REGISTRATION & TUITION Registration Fee – Due at time of registration – NON-REFUNDABLE $ Annual Tuition…………………$ Materials Fee………………….$ Paid in two installments before July 15, 2014 NOTE: Tuition Payments begin June 5, 2014 Pay in 12 monthly payments of $ Emmanuel Academy P O Box 1504 ~ 108 Dansing Street Lake City, SC ENROLLMENT CONTRACT FOR TWO STUDENTS Terms of Agreement I have read this agreement and understand that it is my obligation to pay the fees for educational services rendered to my child(ren) for the academic year stated above. I further understand that in signing this agreement, I am accepting the policies and procedures of Emmanuel Academy on behalf of my child(ren). I understand that if I choose the Budget Payment Plan, 12 monthly payments are due by the 5 th day of each month beginning in June _2014_ and continuing through May of _2015_. I am aware that a late fee of $20.00 will be added to my account for any payments that are more than 7 calendar days late. _______ (initial) I also understand that if my account becomes 45 calendar days past due, it may result in a dismissal of my child(ren) unless the past due amount is brought current. _______ (initial) I further understand that if my child(ren) is withdrawn from school for reasons unrelated to a medical condition as stated in a physician’s letter, the remainder of the year’s tuition is still due and payable. Emmanuel Academy reserves the right to address this type of issue on a case by case basis. _________ (initial) Signature _____________________________________ Date___________________

REGISTRATION & TUITION Registration Fee – Due at time of registration – NON-REFUNDABLE $ Annual Tuition…………………$ * Materials Fee………………….$ (Due by June 15 th ) Pay in 12 monthly payments of $ Emmanuel Academy P O Box 1504 ~ 108 Dansing Street Lake City, SC ENROLLMENT CONTRACT FOR THREE STUDENTS Terms of Agreement I have read this agreement and understand that it is my obligation to pay the fees for educational services rendered to my child(ren) for the academic year stated above. I further understand that in signing this agreement, I am accepting the policies and procedures of Emmanuel Academy on behalf of my child(ren). _______(initial) I understand that if I choose the Budget Payment Plan, 12 monthly payments are due by the 5 th day of each month beginning in June __________ and continuing through May of __________. I am aware that a late fee of $20.00 will be added to my account for any payments that are more than 7 calendar days late.______(initial) I also understand that if my account becomes 45 calendar days past due, it may result in a dismissal of my child(ren) unless the past due amount is brought current.______(initial) I further understand that if my child(ren) is withdrawn from school for reasons unrelated to a medical condition as stated in a physician’s letter, the remainder of the year’s tuition is still due and payable. Emmanuel Academy reserves the right to address this type of issue on a case by case basis._______(initial) Signature _____________________________________ Date___________________

Emmanuel Academy is committed to a grading policy that reflects the most authentic assessment of student work. Therefore, grades will be based on a compilation of both formal and informal assessments of student work. These include daily tasks, quizzes, projects, special assignments, homework, and test scores. Grade Weighting: 40% = major tests or project grades 60% = daily work (homework, quizzes, assignments, etc.) NOTE: If homework is assigned, no more than 10% of the daily work grade may be homework. At least one cumulative test may be given every quarter, but not necessarily the last week of the quarter. Determining Final Course Grades: 1st Semester Average = 40% + 10% Semester Exam 2nd Semester Average = 40% + 10% Course Ending Exam End of Course Exams = 20% of Final Grade HONOR ROLL STANDARDS Director's Honor Roll =All A’s Teacher's Honor Roll =A’s and B’s GRADING SCALE A= B = C = D = F =Below 70 To receive credit for a course, a student must obtain a numerical average of 70 or above when the two-quarter numerical averages are averaged and meet attendance requirements. An incomplete grade of “I” not resolved by the end of the following grading period shall be assigned a numerical grade. This grade will be calculated using zeros for all missed work. Grading and Attendance Policy

ATTENDANCE POLICY The Emmanuel Academy school year consists of 180 school days. Attendance is the presence of a student on days when school is in session. Students may be counted present only when they are actually at school, on homebound instruction, or are present at a school activity which is authorized by the school. This may include field trips, athletic contests, academic contests, music festivals, student conventions and similar activities. Students have an opportunity of 150 hours of instruction in 180 days. Students must have 120 hours of seat time to earn a Carnegie unit (60 hours for a ½ unit). Students must be in attendance 155 days (77 days for a ½ unit). This limits all absences to 25 days (13 days for a ½ unit). This includes all days missed – excused, unexcused, suspensions, bereavement, medical, etc. When students have three (3) consecutive or five (5) total unexcused or unverified absences, the school will contact parents and develop a truancy intervention plan (TIP) for improved attendance. Students under 17 years of age who violate a TIP will be referred to a higher authority for truancy. If students are not in class, they are marked absent! ABSENCES AND EXCUSES Students must bring in an excuse for all absences by the second day they return from the absence. This note must contain a reason for the absence, and be signed by a parent/guardian. The excuses will be filed in the student's cumulative folder. Excuses brought in late must be approved by the director. Excuses submitted after five days will not be accepted. Students are responsible for making up all homework, missed assignments, and tests. STUDENTS WHO MISS SCHOOL FOR UNLAWFUL REASONS WILL BE CHARGED WITH AN UNEXCUSED ABSENCE AND WILL RECEIVE A GRADE OF “0” FOR ALL MISSED WORK. Lawful absences shall include the following: Students who are ill and whose attendance in school would endanger their health or the health of others may be temporarily excused from attendance. Students in whose immediate family there is a serious illness or death. Students may be excused from attendance in school for recognized religious holidays of their faith. Unlawful absences shall include: Students who are willfully absent from school without the knowledge of their parents. Students who are absent from school without acceptable cause, with or without parental consent.

Communication Preferences It is very important that we have the most reliable means of communicating school information and announcements to you. Please provide us with your address(es) and share with us which communication methods you prefer we use to keep you informed: Mother:____________________________________________________ Father:_____________________________________________________ How would you prefer that we communicate information to you? Check all that apply: ____ ____text message ____phone ____facebook message In addition to these methods, we also use TELLBLAST© to broadcast announcements via phone call. Thank you!