Application Form

Student Information

Enrollment Type

Desired Enrollment Date

Today's Date

Enrollment Information

Child's Full Name*

First Middle Last

Child's Preferred Name

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Birthdate*

Gender

Previous School(s) Attended

Guardian 1 Information

Name*

First Last

Current Address

If different from child's address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Preferred Phone*

Preferred Email

Occupation

Business Name

Guardian 2 Information

Name

First Last

Current Address

If different from child's address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Preferred Phone

Preferred Email

Occupation

Business Name

Sibling Information

List

Sibling Name

Sibling Age

Last Name

Preferred Class Enrollment

3 Half Day Program: Designed for children who are 2.5-3 years old only

5 Half Day Program: Designed for children who are 2.5-6 years old only

3 All Day Program: Designed for children who are 2.5-3 years old only

5 All Day Program: Designed for children who are 2.5-6 years old only

Half Day Kindergarten Program: Designed for children 5 years old by Oct. 1

All Day Kindergarten Program: Designed for children 5 years old by Oct. 1

First Grade Program: Designed for children 6 & 7 years old

Check all that apply

Additional Programs Available

Extended Care AM

Extended Care PM

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. A non-refundable enrollment application fee is required with this application. For re-enrollment, this $100 fee will be credited towards your Reservation Fee.

Other Preference

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

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Phone

This field is for validation purposes and should be left unchanged.

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Student Information

Enrollment Information

Guardian 1 Information

Guardian 2 Information

Sibling Information

Additional Information

Summer Camp Enrollment

Summer Montessori Program Enrollement

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