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Student Registration Form
Please complete this form in its entirety.
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Email
*
Your email
Student Legal Full Name
*
Your answer
Street Address
*
Your answer
State
*
Your answer
Zip Code
*
Your answer
Phone number
*
Your answer
Country
*
Your answer
Parent/Guardian Name
*
Your answer
Parent Address
*
Your answer
Parent Telephone/Cell
*
Your answer
Emergency Contact/ Telephone/E-mail
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Student Date of Birth
*
MM
/
DD
/
YYYY
Preferred Language/Languages Spoken
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Grade Level Enrolling for School Year 2020 -21
*
Pre- Kindergarten
Kindergarten
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
Grade 7
Grade 8
Grade 9
Grade 10
Grade 11
Grade 12
Required
Gender
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Previous School Attended City/State
*
Your answer
Student Classification/Identification
General Education
Special Education
English Language Learner
Honors
Gifted and Talented
Previous Grade Level Completed
*
Your answer
Reason for Leaving
Your answer
Student Interests/Hobbies
*
Your answer
Why did you choose Collegiate Prep Academy?
*
Accredited Curriculum Choices
Online Classes
Affordable Tuition
Instructional Program
Themes
Other:
Required
Preferred Payment of Tuition/Fees
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Credit Card/Debit
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Cash App
Check
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