Rose City Classical Academy Application

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Thanks for your interest in Rose City! This is the first step in becoming a member of the Rose City community. Please complete the form below. It may take 20-30 minutes to complete. Generally speaking, all of the prompts are required.

Family Name

Father's Name

Father's Phone Number

Father's Email

Mother's Name

Mother's Phone Number

Mother's Email

Home Address

Family Church

Family Pastor

Are you members of this church?

Yes

Clear selection

If not, explain.

Emergency Contact

Relationship

Phone Number

Does this person have permission to pick up students?

Yes

Students live with...

Father and Mother

Father

Mother

Legal Guardian

Stepfather

Stepmother

Family Status

Parents married

Parents separated

Father deceased

Mother deceased

Parents divorced

Mother remarried

Father remarried

Clear selection

Clear form

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