Admissions Inquiry
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Student's Name
Birth Date
JWRCA does not discriminate on the basis of race, color, gender, nationality and ethnicity, socioeconomic status, age, or disability in the administration of its admission, education, financial assistance, extracurricular policies, or employment policies and other school sponsored programs. Note: As a bona fide religious organization, we impose qualifications based on a bona fide religious purpose. (Refer to school’s doctrinal statement.) Sexual orientation, gender identity, religion, and creed have been excluded from this policy in accordance with Iowa Code 216.9(2) (2003)
Student's Home Address
Do you have other students you wish to register?

Parent/Guardian Information

Parent/Guardian Name
Is your home address the same as the students?

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