New Family Interest Form

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Acceptance into Lightshine Homeschool Academy is based on our interview process and available space. We are thankful to have a high rate of returning families. Each year we do have some space available for new students and we love adding to our Lightshine family.

Lightshine Homeschool Academy is a tight knit Christian community with students in grades Kinder through 12th grade. Our parents are not required to teach or stay on campus all day, but they are required to volunteer with both weekly and yearly jobs.

To begin the registration process, please complete and submit this interest form below. Please make sure to fill out this form completely and accurately to be able to proceed. Only children listed on this form will be considered for enrollment. If you decide to add a child after this form is sent, you will need to fill out the entire form again to add a child and potentially start the interview process over.

This form does not guarantee acceptance and does not commit you to joining.

Our interview process is from February – May each year. On occasion, we review new families outside of this window.

We thank you for your interest in Lightshine Homeschool Academy and look forward to getting to know you!

If you have any questions about the program or registration, please contact us.

Family Information

1. *	Mother's First & Last Name:

2. *	Mother's Email:

3. *	Mother's Phone Number:

4. *	Please provide a brief statement of Mother's personal testimony and how your faith is being walked out.

5. *	Father's First & Last Name:

6. *	Father's Email:

7. *	Father's Phone Number:

8. *	Please provide a brief statement of Father's personal testimony and how your faith is being walked out.

9. *

Who should Lightshine's Admissions Committee contact in regards to your interest in our program?

Mother

Father

10. *	Street Address:

11. *	City:

12. *	State:

13. *	Zip Code:

14.	If you currently do not live in the San Antonio area, when do you plan to move to San Antonio?

15. *	Are mother and father both present in the home?

16. *	How many children do you have living at home?

17. *	What Church do you attend?

18. *

How did you hear about Lightshine Homeschool Academy?

*Please list any families or teachers you know from Lightshine.

19. *	Are you considering other co-ops in addition to Lightshine?

References - We require a minimum of 3 references per family. We have provided a place for a family reference as well as student references after each students information. The references can be the same for each child as long as they have observed that child and you have provided a least 3 different people for your family.

Family Reference:

*This should be someone outside of your family who has seen your children interact with other children, follow directions from a leader, and/or participate in a classroom or group setting.

20. *	First & Last Name:

21. *	Email:

22. *

Relationship:

Church Community		Co-op Community
Current Teacher		Past Teacher
Coach		Family Friend

Student Information

Student #1

23. *	First & Last Name:

24. *	Date of Birth

25. *	Current Grade:

26. *

Gender:

Male

Female

27. *	Does this child have any medical conditions and/or allergy information you would like us to be aware of?

28. *	How would you describe this child's demeanor on a daily basis?

29. *	How does this child interact with their peers?

30. *	How does this child respond when given a task to complete?

31. *

Does this student currently attend a school or co-op program or have they in the past?

If yes, please identify which ones and for how long. (As well as include reference from them in the students reference section below.)

Student References:

*These should be people outside of your family who have seen this child interact with other children, follow directions from a leader, and/or participate in a classroom or group setting.

32. *	First & Last Name:

33. *	Email:

34. *

Relationship:

Current Teacher		Past Teacher
Church Community		Co-op Community
Coach		Family Friend

35. *	First & Last Name:

36. *	Email:

37. *

Relationship:

Current Teacher		Past Teacher
Church Community		Co-op Community
Coach		Family Friend

Additional Students

*Please complete each of the fields below for all school age students in your household. Failure to provide all information for every student in your family on this form will result in the need to complete another form in its entirety before proceeding.

**If you have more than 6 students, complete the form for your oldest and then email us with the additional students information.

Student #2

38.	First & Last Name:

39.	Date of Birth:

40.	Current Grade:

41.	Gender:

42.	Does this child have any medical conditions and/or allergy information you would like us to be aware of?

43.	How would you describe this child's demeanor on a daily basis?

44.	How does this child interact with their peers?

45.	How does this child respond when given a task to complete?

46.

Does this student currently attend a school or co-op program or have they in the past?

If yes, please identify which ones and for how long. (As well as include reference from them in the students reference section below.)

Student References:

*These should be people outside of your family who have seen this child interact with other children, follow directions from a leader, and/or participate in a classroom or group setting.

47.	First & Last Name:

48.	Email:

49.	Relationship

50.	First and Last Name:

51.	Email:

52.	Relationship:

Student #3

53.	First & Last Name:

54.	Date of Birth:

55.	Current Grade:

56.	Gender:

57.	Does this child have any medical conditions and/or allergy information you would like us to be aware of?

58.	How would you describe this child's demeanor on a daily basis?

59.	How does this child interact with their peers?

60.	How does this child respond when given a task to complete?

61.

Does this student currently attend a school or co-op program or have they in the past?

If yes, please identify which ones and for how long. (As well as include reference from them in the students reference section below.)

Student References:

*These should be people outside of your family who have seen this child interact with other children, follow directions from a leader, and/or participate in a classroom or group setting.

62.	First & Last Name:

63.	Email:

64.	Relationship:

65.	First & Last Name:

66.	Email:

67.	Relationship:

Student #4

68.	First & Last Name:

69.	Date of Birth:

70.	Current Grade:

71.	Gender:

72.	Does this child have any medical conditions and/or allergy information you would like us to be aware of?

73.	How would you describe this child's demeanor on a daily basis?

74.	How does this child interact with their peers?

75.	How does this child respond when given a task to complete?

76.

Does this student currently attend a school or co-op program or have they in the past?

If yes, please identify which ones and for how long. (As well as include reference from them in the students reference section below.)

Student References:

*These should be people outside of your family who have seen this child interact with other children, follow directions from a leader, and/or participate in a classroom or group setting.

77.	First & Last Name:

78.	Email:

79.	Relationship:

80.	First & Last Name:

81.	Email:

82.	Relationship:

Student #5

83.	First & Last Name:

84.	Date of Birth:

85.	Current Grade:

86.	Gender:

87.	Does this child have any medical conditions and/or allergy information you would like us to be aware of?

88.	How would you describe this child's demeanor on a daily basis?

89.	How does this child interact with their peers?

90.	How does this child respond when given a task to complete?

91.

Does this student currently attend a school or co-op program or have they in the past?

If yes, please identify which ones and for how long. (As well as include reference from them in the students reference section below.)

Student References:

*These should be people outside of your family who have seen this child interact with other children, follow directions from a leader, and/or participate in a classroom or group setting.

92.	First & Last Name:

93.	Email:

94.	Relationship:

95.	First & Last Name:

96.	Email:

97.	Relationship:

Student #6

98.	First & Last Name:

99.	Current Grade:

100.	Date of Birth:

101.	Gender:

102.	Does this child have any medical conditions and/or allergy information you would like us to be aware of?

103.	How would you describe this child's demeanor on a daily basis?

104.	How does this child interact with their peers?

105.	How does this child respond when given a task to complete?

106.

Does this student currently attend a school or co-op program or have they in the past?

If yes, please identify which ones and for how long. (As well as include reference from them in the students reference section below.)

Student References:

*These should be people outside of your family who have seen this child interact with other children, follow directions from a leader, and/or participate in a classroom or group setting.

107.	First & Last Name:

108.	Email:

109.	Relationship:

110.	First & Last Name:

111.	Email:

112.	Relationship: