Student Registration Form
Please complete this form in its entirety.
Email address *
Student Legal Full Name *
Street Address *
State *
Zip Code *
Phone number *
Country *
Parent/Guardian Name *
Parent Address *
Parent Telephone/Cell *
Emergency Contact/ Telephone/E-mail
Student Date of Birth *
MM
/
DD
/
YYYY
Preferred Language/Languages Spoken
Grade Level Enrolling for School Year 2020 -21 *
Required
Gender *
Previous School Attended City/State *
Student Classification/Identification
Previous Grade Level Completed *
Reason for Leaving
Student Interests/Hobbies *
Why did you choose Collegiate Prep Academy? *
Required
Preferred Payment of Tuition/Fees *
Required
A copy of your responses will be emailed to the address you provided.
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