24-25 NEW CAMPUS Online Application
For New Campus Locations including Boca Raton, Wellington, and Stuart
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Please let us know which Campus Location interests  you. *
Student's First Name *
Student's Last Name *
Student's Preferred Name *
Student's Gender *
Student's Birthdate *
Student's Current School *
Is student in good standing at his/her current school? *
Has student ever been retained in a grade or failed a subject? *
Student's 2022-23 Grade *
2023-24 Grade Level Entering *
CAMPUS CLASSES: Check all classes you are interested in for your student. *
Required
Dad's First & Last name *
Mom's First & Last Name *
Home Street Address *
City *
State *
ZIP *
Do both parents live at home? *
Dad's Cell Phone Number *
Mom's Cell Phone Number *
Dad's Email Address *
Mom's Email Address *
Dad's Occupation and Employer. *
Mom's Occupation and Employer. *
Describe the student's study/school area at home. *
Does the student have access to appropriate research materials? *
Does the student have access to a mentoring adult who has completed college/has college credit? *
Student History: please provide a brief evaluation of the student's prior academic, emotional, and social background. List all academic and social concerns and non-diagnosed and/or formally diagnosed mental, behavioral, or social issues that are present in your student (ex.: disobedience, ADHD, bullying, Asperger's Syndrome, etc.) NOTE: undisclosed academic, mental, behavioral, or social issues and/or concerns may result in dismissal from the program. *
What is your family's church? *
Please provide a narrative of the parent's faith journey/testimony. *
Is the student a follower of Jesus Christ? *
Parent Signature: I certify that all the above information is true. I understand that my non-refundable registration fee must accompany this application for it to be processed and my student to be considered for the program. I understand that upon acceptance the financial contract with be remitted to me. *
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