CBCA Application Form

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This CBCA application is for those families who have NEVER BEEN ENROLLED AT CBCA BEFORE. It is for first time families.

CBCA enrolls students of any race, color, national, or ethnic origin, and affords them all the rights, privileges, programs, and activities generally accorded or made available to all students at the Academy. CBCA does not discriminate on the basis of race, color, or national origin in the administration of its educational policies, admission policies, athletics, and other school-administered programs.

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Parents' Names *

Marital Status: *

Married

Separated

Divorced

Single Parent

Contact info: email and phone number *

Home Street Address *

Please enter your students Name, Birthdate, SS number, Grade Entering, and the Last school attended. *

Please enter the your students Name, Birthdate, SS number, Grade Entering, and the Last school attended.

Reason for leaving last school *

How did you find out about CBCA? *

Church that you regularly attend

Pastor's Name

Student Information: Please put a check mark in front of each item that applies to your student(s)

Learning Disability

Individual Education Plan

Physical Handicap

Hyperactivity

Severe Allergies

Repeated Grades

Resource Room

Expelled or asked to leave school

Muu:

Please give a brief explanation for any item checked above.

I hereby request that the student(s) named above be allowed to enroll at CBCA for the 2024-2025 school year.

Pakollinen

I understand that an interview and possible academic testing will precede acceptance*Note: Acceptance for enrollment is contingent upon receiving the student’s current information including, but not limited to, grades, standardized achievement tests and other application data.

Pakollinen

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Tämä lomake luotiin verkkotunnuksessa Central Baptist Christian Acadamy. Ilmoita väärinkäytöstä

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