Christoper Academy - Student Registration

The mission of Christopher Academy is to support the development of the child by serving individual needs, fostering independence, and protecting the social consciousness within an environment that celebrates a love of learning.

Christopher Academy Student Admission Enrollment Application

Fill out the form below to register your child.

Enrollment Information

Choose Campus

Today's Date

Desired enrollment Date

Student Information

Child's Full Name

Child's Preferred Name

Current Address

Current City

Current State

Current Zip Code

Birthdate

Sex

Previous School(s) Attended

Guardian 1 Information

First Name

Last Name

Current Address (If different from child's address)

Current City

Current State

Current Zip Code

Preferred Telephone

Preferred E-mail

Occupation

Business Name

Guardian 2 Information

First Name

Last Name

Current Address (If different from child's address)

Current City

Current State

Current Zip Code

Preferred Telephone

Preferred E-mail

Occupation

Business Name

Child's Living Arrangements

Child Lives With

Sibling Names

Sibling Ages

Other Family Members Living in Home

Additional Information

Availability Preference

Admission is offered to families as space allows. Please choose above your preference in the event that space is not available in your preferred program.

Other Preference

Enrollment Application Fee

A nonrefundable enrollment application fee of $75 is required with this application.

How did you hear about Christopher Academy?

Other Source

Additional Child Information

Indicate any other information you would like us to know about your family or child in the box above

Enrollment Application Terms & Conditions

By submitting this application you're indicating the following:

I understand this application does not guarantee placement in the program.
I understand this application does not obligate family to enroll.
I understand Christopher Academy does not discriminate on the basis of sex, race, color, ethnicity, national origin, religion, creed, or disability in the administration of its admissions policies or educational goals.

Enrollment Information

Student Information

Guardian 1 Information

Guardian 2 Information

Child's Living Arrangements

Preferred Class Enrollment

Additional Information

Enrollment Application Terms & Conditions