Re-enrollment FormStudent’s First Name*Student's Legal First NameStudent's Middle NameLegal NameStudent's Last Name*Legal NameStudent's Date Of Birth* Date Format: MM slash DD slash YYYY In which academic program is your student currently enrolled?*WorkbookOnlineIn which grade level is your student enrolling?*1st2nd3rd4th5th6th7th8th9th10th11th12thParent CommentsWhen would you like to begin?Please select your preferred start date. We do our best to start your student on the date you select, but it may take up to a week from the time this form is submitted. Thank you for your understanding! Date Format: MM slash DD slash YYYY Mailing Address InformationMailing Address* Street Address or P.O. Box City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Is this a change in your mailing address?YesNoIs this a permanent mailing address change or temporary?PermanentTemporaryShipping Address InformationShipping Address* Street Address or P.O. Box City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Is this a change in your shipping address?YesNoIs this a permanent shipping address change or temporary?PermanentTemporaryEmail Address InformationEmail Address*Please enter the parent's email address. Is there a guardianship change?*Has there been a change in guardianship of this student due to a death, divorce, or other?YesNoNew Guardianship InformationLegal Guardian First Name*Legal Guardian Last Name*Legal Guardian Relationship*Please explain the need for a guardianship change.*Is this guardianship change permanent or temporary?*PermanentTemporary  : : : Parent / Supervisor Agreement  : : : : We have reviewed the Student Re-enrollment Form and to the best of our knowledge, all information provided is complete and accurate. We understand that we are responsible for the tuition payment, which provides for all necessary curriculum assignments, parent answer keys, report cards, and permanent record file. We understand that the registration fee is a one-time payment and is non-refundable. We have read and understand the refund policy of the Academy. Link to Refund Policy We understand that a school year is a maximum of 12 months, beginning on the date of enrollment and ending when the student has completed all curriculum assignments. We understand that if we choose the Quarterly Tuition Payment, it provides for (1/4) one quarter of the school year of materials and should be completed within (3) three months. We understand that a student is placed on the Inactive Roll if we do not send another tuition payment within the three month period and that a Reactivation Fee of $10.00 will be assessed to reactivate our child in the Academy. We further understand that if we do not reactivate our child within (3) three months of his/her Inactive Roll status, our child will not be allowed to return to the Active Roll of this Academy and we will need to seek other educational alternatives. We also understand that if our child is placed on the Inactive Roll more than (2) two times and accumulates more than (4) four months of Inactive Roll status in one school year, our child will not be allowed to return to the Active Roll of this Academy and we will need to seek other educational alternatives. We further understand that if completed assignments are returned after exceeding the Reactivation deadline, the Academy will assess an Extension Fee of $25. We understand that if we choose the Full-Year Tuition Payment, it provides for one school year of materials and should be completed within (12) twelve months. We understand that a student is placed on the Inactive Roll if we do not send another tuition payment within the twelve month period and that a Reactivation Fee of $10.00 will be assessed to reactivate our child in the Academy. We further understand that if we do not reactivate our child within (3) three months of his/her Inactive Roll status, our child will not be allowed to return to the Active Roll of this Academy and we will need to seek other educational alternatives. We further understand that if completed assignments are returned after exceeding the Reactivation deadline, the Academy will assess an Extension Fee of $25. We understand the importance of continual communication channels with the Academy and will contact the Academy office immediately with any changes in our physical, mailing, email addresses, or phone numbers. We further understand that if all communication channels are broken, the student will be withdrawn by the administration of the Academy. We understand that our child is to be under direct adult supervision during study time and that the supervising adult has read and understands the Academy policies and procedures as set forth in the Academy Handbook of Instructions. We agree that the supervising adult will submit our responses to the Academy's Required Compliance Forms that are sent to us via email. We further understand that the supervising adult will require the student to adhere to the Academy procedures, including, but not exclusive of, not copying answers from the Score Keys or Test Keys and by keeping the Test Keys in a secure location, or any Program Abuse (cheating). We agree to submit completed and graded Tests at the end of the first month of enrollment and at the end of each semester term (half-year). We understand that Christian Academy of America reserves the right to withdraw students and withhold grades of any student that is found to be in Program Abuse or parent in Non-Compliance of Academy procedures, and will be charged a Reactivation Fee of $10.00, if reinstated.By entering our names in the Signature boxes, we understand and agree with the above statements and also verify the information entered is correct to the best of our knowledge. Parent / Supervisor Agreement We have reviewed the Student Re-enrollment Form and to the best of our knowledge, all information provided is complete and accurate. We understand that we are responsible for the tuition payment, which provides for all necessary online curriculum access, ID's and passwords, report cards, and permanent record file. We understand that the registration fee is a one-time payment and is non-refundable. We have read and understand the refund policy of the Academy. Link to Refund Policy We understand that a school year is a maximum of 12 months (6 months per semester), commencing on the date of enrollment and ending when the student has completed all curriculum assignments. We understand that if we choose the Monthly Tuition Payment, our student will have access to the online assignments for one month at a time. If we choose the Quarterly Tuition Payment, it provides access for two months and after the final quarter tuition payment is made, our student will have access until the twelve-month period has expired or that grade level is complete. We understand that if a tuition payment is late that our student will be placed on the Inactive Roll and that a Reactivation Fee of $10.00 will be assessed to the tuition payment to reactivate our student in the Academy. We further understand that if we do not reactivate our student within (3) three months of his/her Inactive Roll status, our student will not be allowed to return to the Active Roll of this Academy and we will need to seek other educational alternatives. We also understand that if our child is placed on the Inactive Roll and accumulates more than (4) four months of Inactive Roll status in one school year, our student will not be allowed to return to the Active Roll of this Academy and we will need to seek other educational alternatives. We understand that if we choose the Full-Year Tuition Payment, it provides for one school year of online access and should be completed within (12) twelve months. We understand that a student is placed on the Inactive Roll if we do not send another tuition payment within the twelve-month period and that a Reactivation Fee of $10.00 will be assessed to reactivate our student in the Academy. We further understand that if we do not reactivate our student within (3) three months of his/her Inactive Roll status, our student will not be allowed to return to the Active Roll of this Academy and we will need to seek other educational alternatives. We understand the importance of continual communication channels with the Academy and will contact the Academy office immediately with any changes in our physical, mailing, email addresses, or phone numbers. We further understand that if all communication channels are broken, the student will be withdrawn by the administration of the Academy. We understand that our child is to be under direct adult supervision during study time and that the supervising adult has read and understands the Academy policies and procedures as set forth in the Academy Handbook of Instructions. We agree that the supervising adult will submit our responses to the Academy's Required Compliance Forms that are sent to us via email. We further understand that the supervising adult will keep the Teacher ID and Password in a secure location and that no one except the supervising adult will have access to it. We understand that all assignments, projects and quizzes must be completed before credit is awarded or a student is promoted to the next grade. No assignments, quizzes, or tests are to be skipped. We also understand that students are required to complete at least one project per unit, except for P-B Electives (Project-Based Electives). We understand that Christian Academy of America reserves the right to withdraw students and withhold grades of any student that is found to be in Program Abuse (cheating or plagiarism) or in Non-Compliance of Academy procedures, and will be charged a Reactivation Fee of $10.00, if reinstated. By entering our names in the Signature boxes, we understand and agree with the above statements, and verify the information entered is correct to the best of our knowledge.Signature*Phone Number InformationParent Phone Number*Name and relationship of the Supervisor responsible to administer this home school program:*Example: Mary Jones - Mother Dora Smith - TutorHas this person read the Supervisor Agreement and consented to abide by all the regulations as set forth in the Handbook of CAA?*YesNoIs there a person(s) that you would like to add to the list of individuals with whom student information may be shared?Please list any names of relatives or non-family person's and their relationship to the student, with whom the student's Academic Advisor may discuss the student's academic information (tutors, grandparents, non-custodial parent, etc.).Reenrollment Fee:Reenrollment Fee: $30.00 / studentTuition Fee:Before your student may begin classes a tuition payment must be made.Total Fees:*Reenrollment Fee plus TuitionPayment DetailsYou may confidently submit this Reenrollment Form with your credit card information. If you are not submitting card information, type "N/A" in each field and call the Academy office to pay by phone. C.A.A. does not accept personal checks.Type Of Card Visa Mastercard American Express DiscoverCredit Card #*Expiration Date*Security Code*Name on Account*Billing Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Date Date Format: MM slash DD slash YYYY
Christian Academy Of America
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