Cornerstone Charter Academy: A Challenge Foundation Academy
Application for Enrollment for 2017-2018
Student Information
Student's Legal First Name *
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Student's Legal Middle Name
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Student's Legal Last Name *
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Student's Preferred Name
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Student's Date of Birth *
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DD
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Applying for Grade (K-10) *
Current School Information
This information is for School Planning purposes; this information has no bearing on admission.
Student's Current Grade *
Name of Student's Current/Most Recent School: *
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Address & Phone # of Student's Current/Most Recent School: *
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Sibling/Staff Preferences
Does the applying Student have any siblings currently attending CCA-CFA? *
If Yes, what are the Sibling Name(s) & Grade(s)
If applicable
Your answer
Are the Parent/Guardians Staff Member at CCA-CFA? *
If Yes, name of Staff Person:
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Parent/Guardian Information
**If your household is a split household, please make sure you list both addresses below.
Student lives with: *
Please check all that apply
Required
Name of Parent 1: *
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Relationship to Student *
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Address *
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City *
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State *
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Zip Code *
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County of Residence *
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Home Phone *
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Cell Phone *
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Email *
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Name of Parent 2:
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Relationship to Student
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Address
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City
Your answer
State
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Zip Code
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County of Residence
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Home Phone
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Cell Phone
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Email
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