Post on 18-May-2018
California Crosspoint Academy 25500 Industrial Blvd., Hayward, CA 94545 Tel: (510) 995-5333 Fax: (510) 995-5335
Revised 11/18/16
1 OF 1
California Crosspoint Academy “Transforming Lives for the Glory of God”
Dear Prospective Family:
Thank you for your interest in California Crosspoint Academy. Your child’s education and training are
very important to us and we want to assist you in making the right choice. Every school is different and not
every learning environment is best suited for every child. California Crosspoint Academy offers an excellent
and comprehensive college-preparatory academic program in a highly structured but supportive learning
community. We encourage you to visit many schools and to ask a lot of questions. Be sure you pick the
school that is the best match for your child.
California Crosspoint Academy is neither elitist nor exclusive in its admissions policy. Our ministry goal
is to develop each student’s God-given potential to the fullest. We desire to help all students who can benefit
from our educational program. Students are admitted without regard to race, color, religion, and national or
ethnic origin. As a private, religious school, we reserve the right to make admissions decisions in accordance
with our religious beliefs and mission.
The submission of an application begins the admissions process. Each application is reviewed by the
registrar for completeness and submitted to school administration for consideration. The school administrators
carefully examine each application and determine what action to take in accordance with God’s Will, the
school’s mission, and ministry impact. Some of the factors that are weighed include:
church/school connection (children of Bay Area Chinese Bible Church members, siblings of
current students, and children of staff or alumni have priority),
prior academic performance,
conduct, discipline, and maturity,
student’s parent and family support structure,
church and religious background, and
time of application.
If you have special facts or circumstances in the areas listed above that the school should consider with
your application, please include a separate, detailed explanation.
We will make every effort to act on your application as quickly as possible. If you have any questions,
please do not hesitate to contact us. Thank you again for your interest in California Crosspoint Academy.
Sincerely yours,
Mr. Robin S. Hom
Superintendent
California Crosspoint Academy 25500 Industrial Blvd., Hayward, CA 94545 Tel: (510) 995-5333 Fax: (510) 995-5335 Revised 11/18/16
1 OF 1
California Crosspoint Academy “Transforming Lives for the Glory of God”
ADMISSIONS PROCEDURES
1. Complete the Admissions Application and return it with the following:
a. Current immunization record
b. Authorization to Release Reference Information
c. Copy of your child’s last two years’ report cards
d. Copy of your child’s last two years’ standardized test results (e.g., CAT, SAT, CTBS etc)
e. Student Questionnaire
f. Teacher’s Reference/Recommendation
g. Birth Certificate
2. Once all the forms have been received, our admissions office will contact you to schedule a
placement test date. Your child will take a placement test and meet with an administrator.
3. We would like both parents to attend a personal interview with an administrator if possible.
4. An admission and placement evaluation and decision will be made by a staff team based on the
following:
a. Parents and student agreement with the school’s philosophy and policies
b. Student’s academic grade level proficiency
c. Student’s learning attitude and effort
d. Student’s conduct and classroom behavior
e. School’s ability and resources to meet the student’s needs
California Crosspoint Academy 25500 Industrial Blvd., Hayward, CA 94545 Tel: (510) 995-5333 Fax: (510) 995-5335
1 OF 4
California Crosspoint Academy “Transforming Lives for the Glory of God”
ADMISSIONS APPLICATION
Student Information
LEGAL LAST NAME LEGAL FIRST NAME
PREFERRED NAME PRIMARY LANGUAGE
SCHOOL YEAR APPLYING FOR
20_____
GRADE APPLYING FOR CURRENT GRADE
□ MALE □ FEMALE PASSPORT NUMBER
ID#/SOCIAL SECURITY NUMBER
STREET ADDRESS
CITY PROVINCE/STATE COUNTRY ZIP CODE
HOME PHONE
DATE OF BIRTH PLACE OF BIRTH (City, State, Country)
STUDENT’S CELL PHONE STUDENT’S DRIVER’S LICENSE
Parent Information
FATHER MOTHER
LAST NAME, FIRST
STREET ADDRESS
CITY
PROVINCE /STATE
ZIP CODE
COUNTRY
HOME PHONE
( ) - ( ) -
CELL PHONE
( ) - ( ) -
EMPLOYER
OCCUPATION
WORK PHONE
( ) - ( ) -
PRIMARY LANGUAGE
California Crosspoint Academy 25500 Industrial Blvd., Hayward, CA 94545 Tel: (510) 995-5333 Fax: (510) 995-5335
2 OF 4
Family Information
PARENTS’ MARITAL STATUS:
□ MARRIED
□ WIDOWED
□ DIVORCED
□ SEPARATED
SEND SCHOOL NOTICES TO: (Check all that apply)
□ JOINT
□ FATHER
□ MOTHER
□ GUARDIAN
LEGAL CUSTODY OF THE CHILD IS WITH:
□ JOINT
□ FATHER
□ MOTHER
□ GUARDIAN
SPECIAL CUSTODY OR VISITATION ARRANGEMENTS
BROTHERS or SISTERS LIVING AT HOME
NAME BIRTHDATE SCHOOL ATTENDING GRADE
Academic Information
LAST SCHOOL ATTENDED
GRADE LEVEL AVG. HRS. OF HOMEWORK PER NIGHT:
SCHOOL ADDRESS SCHOOL PHONE
CITY SCHOOL FAX NUMBER
PROVINCE /STATE ZIP CODE SCHOOL WEBSITE
REASON FOR LEAVING PREVIOUS SCHOOL:
HAS THE STUDENT EVER BEEN EXPELLED, SUSPENDED, PLACED ON PROBATION, OR INVOLVED IN AN INCIDENT INVOLVING
VIOLENCE, DRUG ABUSE, GANGS, VANDALISM, OR LAW ENFORCEMENT? IF YES, EXPLAIN FULLY.
LIST ALL REQUIRED PHYSICAL OR ACADEMIC ACCOMODATIONS MADE IN SCHOOL LAST ATTENDED:
PLEASE INCLUDE ANY ADDITIONAL INFORMATION YOU WOULD LIKE THE SCHOOL TO KNOW.
California Crosspoint Academy 25500 Industrial Blvd., Hayward, CA 94545 Tel: (510) 995-5333 Fax: (510) 995-5335
3 OF 4
STUDENT QUESTIONNAIRE
1) What are your favorite subjects and why?
2) Write about something you learned that was very important, valuable, and exciting to you. Is there something else that you have always wanted to do or learn?
3) What qualities do you like and value most about yourself? What personal qualities would you like to improve?
4) Describe a person you admire and look up to. Why do you respect this person? How is this person important to you?
5) What are your plans for college?
6) What occupation or profession do you want to enter? Why?
7) Why do you think you will do well in a structured environment where a student’s conduct, speech, character, and attitude are emphasized as much as academics?
8) List any church or religious activities you attend regularly:
9) Briefly describe your spiritual life. Are you a born-again Christian? Have you been baptized? Do you pray or read the Bible?
10) Do you want to attend California Crosspoint Academy? Why or why not?
California Crosspoint Academy 25500 Industrial Blvd., Hayward, CA 94545 Tel: (510) 995-5333 Fax: (510) 995-5335
4 OF 4
California Crosspoint Academy, 25500 Industrial Blvd., Hayward, CA 94545 Tel: (510) 995-5333 Fax: (510) 995-5335
Revised 11/3/2016
1 OF 1
California Crosspoint Academy “Transforming Lives for the Glory of God”
AUTHORIZATION TO RELEASE REFERENCE INFORMATION
(including academic, medical, psychological, and disciplinary records)
________________________ has made application to enroll in California Crosspoint Academy. As
parent or guardian, I have authorized California Crosspoint Academy to thoroughly investigate
references, academic records, evaluations, discipline, and other matters related to my child’s suitability
for enrollment.
I authorize references and staff from my child’s former school(s) to disclose to California Crosspoint
Academy any and all school applications, academic records, progress reports, disciplinary, medical or
psychological reports, and other information related to my child’s academic and school life, without
giving me prior notice of such disclosure.
In addition, I hereby release California Crosspoint Academy, my child’s former school(s), and their
staff, references, and all other parties from any and all claims, demands, or liabilities arising out of or
in any way related to such investigation or disclosure.
I waive the right to ever personally view any references given to California Crosspoint Academy.
I agree that a photocopy or facsimile copy of this document and any signature shall be considered for
all purposes as the original signed release on file.
I certify that I have carefully read and do understand the above statements.
Applicant’s Name (Print) _____________________________ Current Grade __________________
Parent or Guardian’s Signature __________________________________ Date __________________
Applicant’s Birth Date ______________________________ Social Security # __________________
California Crosspoint Academy Address: 25500 Industrial Blvd., Hayward, CA 94545 Phone: 510.995.5333 Fax: 510.995.5335
To the Parent: We are requesting that your child’s Academic counselor or homeroom teacher complete this form. Please send it with your child’s application. California Crosspoint Academy reserves the right to verify the references given.
Student Assessment
Student’s Name: Grade Level: School phone #: Core Teacher: Teacher ‘s signature: School Seal: Student’s Personal Qualities: (check the most appropriate box for each characteristic)
No
chance to
observe
Characteristic Below
Average
Average
(top 25-
50%)
Good
(top 11-
24%)
Excellent
(top 10%)
Superior
(top 5%)
Academic Ability
Inquisitiveness
Creativity
Self-Confidence
Leadership Potential
Teachability
Concern for Others
Behavior/Conduct
Honesty
Independence
Personal Maturity
1. Does this student’s grades and test scores accurately reflect his/her strengths and abilities?
Yes No (If no, please explain) 2. Has the student ever had a serious discipline issue? No Yes (If yes, please explain) 3. What three words first come to mind when thinking of this student? Please write a recommendation letter on the back of this sheet or on a separate sheet of letterhead as to why you think this student will be successful studying in CCA.