Rock Creek Community Academy Admission Form
Thank you for your interest in Rock Creek Community Academy!

Please fill in the information requested below, you will receive confirmation once this is submitted.

Administration will contact you as soon as everything is processed.
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Email *
Student's Last Name *
Student's First Name *
Gender *
Date of Birth *
Current Student Grade *
Grade Applying For *
Siblings Currently Enrolled or Applying
Last School Attended *
Has your student ever been suspended/expelled from school? *
If yes, please explain the situation - dates, etc.

Mother's Name: *
Mother's Address, City, State and Zip Code *
Mother's Primary Phone Number *
Father's Name: *
Father's Address, City, State and Zip Code *
Father's Primary Phone Number *
A copy of your responses will be emailed to the address you provided.
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