2020-2021 Registration Application 4th-12th Grade
We encourage you to print out the current schedule or have it open in another window while filling this out. See course descriptions for tuition cost of each class.
Email address *
Student's Last Name *
Your answer
Student's first name *
Your answer
Grade in Fall of 2020-21* *
Your answer
Gender *
Your answer
Student email
Your answer
Mother's name (first and last) *
Your answer
Mother's primary phone number *
Your answer
Father's name (first and last)
Your answer
Father's primary phone number
Your answer
Alternate phone number for parents
Your answer
Email(s) to receive Ecclesia and/or Protégé communications *
Your answer
Emergency Contact (Name, relationship, phone) *
Your answer
What is your school of record *
Do you intend to pay for classes with charter fees (Please also specify, later in the form, when choosing each class whether you will be using charter funds to pay) *
Math/Period 1 - Tu/Th 9-10 *
Required
Science/Period 2 (Tu/Th 10-11) *
Required
PE, Art & Worldview/Period 3 (Tu/Th 11-12) *
Required
Language Arts/Period 4 *
Required
Social Studies/Period 5 *
Required
Monday Electives - 7th and up *
Required
For what classes do you plan to pay with charter funds? (check all that apply) *
Required
I have read an understood the Registration Terms of Agreement *
Required
Signed: *
Your answer
Is there anything else you would like us to know?
Your answer
Include your mailing address below. *
Your answer
A copy of your responses will be emailed to the address you provided.
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