Application

Children of Christ Academy Student Application Form

Welcome to Children of Christ Academy! Please complete the form below to apply for admission.

"*" indicates required fields

Student Information

Full Name*

Date of Birth*

Gender*

Male

Female

Other

Grade Applying For*

Home Address*

Parent/Guardian Information

Primary Parent/Guardian

Full Name*

Relationship to Student*

Phone Number*

Email Address*

Secondary Parent/Guardian

Full Name*

Relationship to Student*

Phone Number*

Email Address*

Educational Background

Previous School Name

School Address

Dates Attended

Reason for Leaving

Academic Achievements

Medical Information

Allergies (if any)

Medications (if any)

Special Needs (if any)

Family Information

Primary Parent/Guardian Occupation

Secondary Parent/Guardian Occupation

Family Background (brief description)

Additional Information

Why do you want your child to attend Children of Christ Academy?*

What are the student’s interests and hobbies?*

Any additional comments or information you’d like us to know:

References

Please list two references who are not relatives (teachers, pastors, coaches, or community leaders).

Reference #1 Name

Relationship

Phone or Email

Reference #2 Name

Relationship

Phone or Email

Signatures

Signature of Primary Parent/Guardian*

Date

Signature of Secondary Parent/Guardian*

Date

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Children of Christ Academy Student Application Form

Student Information

Parent/Guardian Information

Primary Parent/Guardian

Secondary Parent/Guardian

Educational Background

Medical Information

Family Information

Additional Information

References

Please list two references who are not relatives (teachers, pastors, coaches, or community leaders).

Signatures

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Site Links

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