TJCA-CFA Initial Application form for 2017-2018
DEADLINE TO SUBMIT MARCH 15TH 2017

In accordance with our charter, students will be placed in the appropriate grade based upon standardized test measurements supplied by the prior school or a TJCA administered MAP test prior to grade level lottery.

All 10th-12th grade applicants must also send a copy of his/her transcript as well as any SAT, PSAT, ACT or other standardized scores to the high school office. Please e-mail to kearle@tjca.org or mail to 2527 US Hwy 221A Mooresboro, NC 28114

Is this NEW student a sibling of a currently enrolled student? *
If you answered yes, please write name/grade of sibling currently attending TJCA
Name of enrolled student
Your answer
Please state the grade this application is for in next school year 2017-2018 *
What grade will your student be in 2017-2018?
Please enter the total number of sibling applications being submitted by you for this year *
How many NEW applications are you submitting this year
Your answer
New Student Legal Last Name *
Your answer
New Student First Name *
Your answer
New student preferred name/AKA
Your answer
New Student Date of Birth *
MM
/
DD
/
YYYY
New Student Middle Name
Your answer
State *
Your answer
Street Address *
physical address (and Appt. # if applicable)
Your answer
City *
Your answer
Zip Code *
Your answer
*Mailing Address (if different from above)
(for example a PO Box # )
Your answer
Mailing City
Your answer
Mailing State & Zip Code
Your answer
COUNTY OF RESIDENCE *
Your answer
Name of student's current or most recent school *
Your answer
Address of Current School *
Your answer
School Telephone number *
Your answer
School Fax number *
Your answer
Please indicate the type of school
School County
Your answer
PARENT GUARDIAN INFORMATION: Student lives with: *
Required
If Other or Joint Custody, please give details and specify
Give details of who is responsible for the student.
Your answer
Parent/Guardian 1 - Please Give Full Name *
Your answer
Relationship to Student (P1) *
Your answer
Home Telephone Number - Please include area code (P1) *
Your answer
Cell Phone Number - Please include area code (P1) *
Your answer
Email Address (P1) *
Your answer
Work Telephone number - Please include area code (P1)
Your answer
Parent/Guardian 2 Please Give Full Name
Your answer
Relationship to Student (P2)
Your answer
Home Telephone Number - Please include area code (P2)
Your answer
Cell Phone Number - Please include area code (P2)
Your answer
Email Address (P2)
Your answer
Work telephone number - Please include area code (P2)
Your answer
Submit
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