Student KCS Application

STUDENT KCS APPLICATION

Application Details

Application Date:    Intake Term/Year:    Application Type: New Enrollment Re-enrollment Transfer

Student Information

Date of Birth:    Student ID (if known):    Grade/Program Applying For:

Date Last Attended (if applicable):    Cumulative GPA:    Current or Most Recent Grade Level:

Student Contact & Residence

Primary Phone:    Secondary Phone:    Email:

Parent / Guardian Information

Relationship:    Phone:    Email:

Emergency Contact & Medical Information

Relationship:    Phone:    Alternate Phone:

Immunizations up to date: Yes No    Has an IEP or 504 plan: Yes No

Program Selection & Enrollment Preferences

Program Applying For:    Desired Start Date:

After-school program    Transportation services    Meals plan

Documentation Checklist

Applicants must submit required documents. Please indicate attached items:

Birth certificate / proof of age
Academic transcript / report card
Immunization record
Proof of residency
Special education records (if applicable)

Tuition, Fees, and Financial Responsibility

Annual Tuition Amount: $    Enrollment Deposit: $

Annual payment (due by start date)
Semester plan
Monthly installment plan

By submitting this application, the undersigned acknowledges financial responsibility for tuition and fees assessed according to the school's published schedule, including any collection costs incurred for unpaid balances. A non-refundable deposit is required to secure placement unless otherwise agreed in writing by authorized school personnel.

Authorizations, Consents, and Acknowledgments

I certify that the information provided in this application is true, complete, and accurate to the best of my knowledge. I understand that knowingly providing false information may result in denial of admission or later dismissal. I authorize the release and exchange of educational records between previously attended schools and KCS for purposes of enrollment evaluation.

Medical and Emergency Treatment Authorization: In the event of an emergency and the parent/guardian cannot be reached, I authorize school officials to seek and consent to emergency medical treatment for the student. I agree to assume financial responsibility for any emergency medical care provided.

Media Release: I grant permission for the student to be photographed, videotaped, or otherwise recorded during school activities and for such materials to be used by the school for educational, promotional, or archival purposes unless I indicate otherwise below.    Grant Do Not Grant

Transportation Consent: I authorize the student to ride school-provided transportation where applicable and agree to abide by the school's transportation rules and any fees associated with this service.

Records & Confidentiality: The school will maintain student records in accordance with institutional policy. By submitting this application I consent to the collection and use of personal information for legitimate educational and administrative purposes and understand the institution's obligation to maintain confidentiality of student records consistent with its policies.

Withdrawal and Refund Policy: Withdrawal after enrollment may result in liability for tuition and fees as provided in the school's published refund schedule. The school may withhold records for unpaid obligations as permitted by institutional policy.

Special Circumstances & Additional Information

Certification

By signing below, I confirm that I am the parent or legal guardian of the applicant or the applicant is of legal age to enroll independently. I have read and agree to the statements, policies, and obligations set forth in this application. I acknowledge that acceptance is contingent upon review of the application, required documentation, and the school's admission decision.

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