Union Springs Academy Student Application

Basic Info


Residence
Dorm
Village








Sex
Male
Female








Spiritual & Lifestyle

Are you desirous of living a christian life?
No
Yes
Do you want to be a student at USA?
No
Yes
Do you attend church regularly?
No
Yes
Have you been baptized?
No
Yes

Have you ever smoked?
No
Yes

Have you ever used alcohol or illegal drugs?
No
Yes

Have you ever been arrested/convicted of a crime?
No
Yes

Have you ever been suspended from school?
No
Yes

Family Information

Parents' Marital Status


Is student adopted?
No
Yes

Student lives with

Siblings:









Mother's Information:

Living
Deceased








Father's Information:

Living
Deceased








Educational Information

If you attended the same school in consecutive years, just enter 'Same' as the School Name for the next years.

8th Grade









9th Grade








10th Grade








11th Grade








Financial & General Information

I will be applying for financial aid through my home church. (deadline August 15th)
No
Yes
Does your child have an unpaid school bill?
No
Yes