Rural Community Academy Application for Admission (Enrollment for New Students)
Please complete a separate application for each child. Once submitted, you will be contacted by the RCA office with further registration instructions.
Sign in to Google
to save your progress.
Name of Parent or Guardian:
Child's Full Name (first, middle, last)
I am enrolling my child for:
RCA School (daily attendance at RCA)
RCA Online (daily attendance online from home, option available for 1st-8th grade only)
How did you hear about us?
Word of Mouth
Staff Member Referral (Please check "other" as well, and list the staff member's name.)
Current RCA Family Referral (Please check "other" as well, and list the RCA family's name.)
Ethnicity (please select all that apply):
Black or African American
Native Hawaiian or other Pacific Islander
Hispanic or Latino
Date of Birth:
Siblings currently attending RCA: (please list names and grade level for the upcoming school year)
Siblings currently NOT attending RCA:
I am interested in bus transportation:
Do you have any concerns you would like to address with our staff at this time? If none, please type: N/A
Page 1 of 2
Never submit passwords through Google Forms.
This form was created inside of Rural Community Academy.