Enrollment Form, Page 2
Has your child had any serious accidents or injuries?

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Does your child have any physical or emotional difficulties that the school should note?

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Remarks or additional information which aids us in knowing your child:

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Please indicate previous schools attended other than Nursery Schools:

School:
Address:
Years Attended:
Reason for leaving:

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School:
Address:
Years Attended:
Reason for leaving:

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Church Affiliation:

Church Affiliation: 		Address City, St, Zip-Code

Denominational Preference:
All information given on this form is true to the best of my knowledge.
Parent's Signature:
Date:
        

Jubilee Christian School admits students of any race, color, national and ethnic origin to all the rights, privileges, programs, and activities generally accorded or made available to students at the school. It does not discriminate on the basis of race, color, national and ethnic origin in administration of its educational policies, admissions policies, scholarship and loan programs, and athletic and other school-administered programs


Jubilee Christian School ~ 255 Washington Road, Mt. Lebanon, PA 15216  
Phone: 412-561-5917  ~  Fax: 412-561-2857
E-Mail: judi.phelps@jubileechristianschool.org