Registration Form
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Email *
Student's  Full Legal Name *
Student's Nickname
Grade *
Date of Birth *
MM
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DD
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YYYY
Birthplace (City & State, or other Country) *
Has the student been baptized? *
If so, when and where was the baptism?
Place of church membership
Address *
Who does the child live with? *
Required
Name of Father (or guardian) *
Father's e-mail address
Father's birthplace
Father's citizenship
Father's religious affiliation
Father's occupation
Father's work phone
Father's cell phone
Name of Mother (or guardian) *
Mother's e-mail address
Mother's birthplace
Mother's citizenship
Mother's religious affiliation
Mother's occupation
Mother's work phone
Mother's cell phone
Names and ages of siblings in the home
Person to notify in case of an emergency, if unable to reach parents (name, phone number, relation to child) *
Another person to notify in case of an emergency, if unable to reach parents (name, phone number, relation to child)
Please list those who have permission to pick your child up from school
Name of last school attended
Why have you chosen College Park Christian Academy? *
I understand that completing this form does not guarantee enrollment.  Registration requires both the registration form and registration fee of $275.  This is a first step to the enrollment process.  The office will contact you to provide any additional forms or to request documents that may be needed prior to the start of the school year. *
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