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Registration Form 2022-2023
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* Required
Email
*
Your email
Untitled Title
Student's Full Legal Name
*
Your answer
Student's Nickname
Your answer
Grade
*
Transitional Kindergarten
Kindergarten
First Grade
Second Grade
Third Grade
Fourth Grade
Fifth Grade
Sixth Grade
Seventh Grade
Eighth Grade
Freshman
Date of Birth
*
MM
/
DD
/
YYYY
Birthplace (City & State, or other Country)
*
Your answer
Has the student been baptized?
*
Yes
No
If so, when and where was the baptism?
Your answer
Place of church membership
Your answer
Address
*
Your answer
Who does the child live with?
*
Father
Mother
Other:
Required
Name of Father (or guardian)
*
Your answer
Father's e-mail address
*
Your answer
Father's birthplace
Your answer
Father's citizenship
Your answer
Father's religious affiliation
Your answer
Father's occupation
*
Your answer
Father's work phone
Your answer
Father's cell phone
*
Your answer
Name of Mother (or guardian)
*
Your answer
Mother's e-mail address
*
Your answer
Mother's birthplace
Your answer
Mother's citizenship
Your answer
Mother's religious affiliation
Your answer
Mother's occupation
*
Your answer
Mother's work phone
Your answer
Mother's cell phone
*
Your answer
Names and ages of siblings in the home
Your answer
Person to notify in case of an emergency, if unable to reach parents (name, phone number, relation to child)
*
Your answer
Another person to notify in case of an emergency, if unable to reach parents (name, phone number, relation to child)
Your answer
Please list those who have permission to pick your child up from school
Your answer
Name of last school attended
Your answer
How did you hear about CPCA? If you would like to give a friend credit for making a referral, please write their name on the other line.
*
our website
Facebook
College Park Christian Preschool
Columbia Seventh-day Adventist Church
Other:
Required
Why have you chosen College Park Christian Academy?
*
Your answer
I understand that completing this form does not guarantee enrollment. Registration requires both the registration form and registration fee of $275. This is a first step to the enrollment process. The office will contact you to provide any additional forms or to request documents that may be needed prior to the start of the school year.
*
Agree
Disagree
A copy of your responses will be emailed to the address you provided.
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