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119B N. Klevin
Anchorage, AK 99508
TVCS Student Application


                                      Term   Date

Last Name  First Name   Middle 

Address   City   State ZIP 


Age Sex  Birth Date  Birthplace

School Last Attended
Last Grade Completed

             Family Information

Father's Name
      Employment   Position
      Business Phone  Cell# Email

Mother's Name
      Employment   Position
      Business Phone   Cell#   Email

Emergency telephone number, other than those already listed:
Marital Status: Married Divorced  Widow  Separated

Children in family of school age if not applying:
          Name  Age

Reason they are not applying:


Church Attending   Pastor  Phone
Father: Christian? Yes  No  Mother: Christian? Yes  No
Has applicant ever made a profession of faith in Christ? Yes  No


Family Physician   Phone#
Does student have any physical defects or allergies? Yes  No
          If yes, please explain:
Has student received immunizations: Diphtheria   Smallpox   Polio


Has student ever been expelled, dismissed, suspended, or refused admission to another school? Yes No
          If yes, please explain:
Has student ever had disciplinary difficulty at school? Yes No
          If yes, please explain:
Does student have a juvenile or arrest record? Yes No
          If yes, please explain:
Has student ever used tobacco or nonprescription drugs of any kind? Yes No
          If yes, please explain:
Please indicate academic level of student's previous work: Excellent  Good  Average  Poor
Has student ever failed an academic subject in school? Yes No
          If yes, please explain:


How did you hear about this school?
Reason for selecting this school:

Application must be filled out completely  before it can be processed. Application, Registration, and Testing Fees of $
must accompany Application and are not refundable. An interview with the parents and the student will be required before final

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