Student Application – OldNew Student Application Due to the high volume of new enrolling students, please allow 2-3 weeks for processing applications. Step 1 of 10 - Student Information10%New Student ApplicationStudent InformationStudent’s First Name*Student's Legal Name (Not a Nickname)Student's Middle NameLegal NameStudent's Last Name*Legal NameStudent's NicknameThe name most used for this studentStudent's Date Of Birth* Month Day YearGender* Female MaleHiddenAdult Yes NoPrevious/current grade level.*(choose one)NonePre-KK1st2nd3rd4th5th6th7th8th9th10th11th12thGrade level for which student is enrolling.*(choose one)Pre-KK1st2nd3rd4th5th6th7th8th9th10th11th12thHow did you hear about us?* Internet Word of mouth Please enter any pertinent information concerning your child and his/her educational needsPrevious School InformationLast School Attended*Previous School's Address* City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State Date student was withdrawn/will be withdrawn* MM slash DD slash YYYY Race/Ethnicity* American Indian or Alaskan Native Asian Black or African American Hispanic or Latino Native Hawaiian or Pacific Islander White OtherHave you had a student enrolled in Christian Academy of America?*If this student, or any sibling, has been enrolled in C.A.A., please mark 'yes'. Yes NoPreviously Enrolled Student’s Full NamePlease enter the previously enrolled student's Full NameParent/Guardian InformationFather’s First Name*Father's Last Name*Father's Relation to Student* Father Step-Father GuardianMother’s First Name*Mother’s Last Name*Mother’s Relation to Student* Mother Step-Mother GuardianMarriage Status of Parents* Married Single Parent Divorced Domestic Partners Separated**Legal Guardian First Name*Legal Guardian Last Name*Legal Guardian Relationship***If separated, both parents/guardians must sign the Parent Agreement at the bottom of this form. The other parent may give consent by email.Shipping 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 Mailing Address* Same as Shipping 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 Mobile Phone*Home PhoneWork PhoneParent's Email Address* Enter Email Confirm Email Please Note: The Academy communicates to parents extensively by email. Please do not use the student's email address.Do you have a High Speed Internet connection?* Yes NoProgram OptionsYour Application will continue based on your program preference.Program Preference* Kindergarten Program (Workbook) Workbook-style for 1st - 12th Grades On-Line School (Grades 3 - 12 only) (Requires reliable, hi-speed, internet connection)Please indicate if you prefer the Online or Workbook program. There are advantages to each program. You may want to call and discuss the advantages of either with one of our education consultants.Start Date Preference* MM slash DD slash YYYY Program KindergartenRegistration: (One Time Fee)* $65Applications must be accompanied by a registration fee. Tuition may be submitted at a later date, but must be submitted a minimum of two weeks before the start date.Tuition OptionsWhen enrolling multiple students, if you would like to receive the multiple student discount, only submit the application(s) with registration. Do not include tuition. After submitting the application(s), call the office to submit the tuition. Option 1: $595. Full Year (1 installment) Option 2: $357. Semester (2 installments) Not at this timeTotal $0.00 Program WorkbookRegistration: (One Time Fee)* 1st - 8th grades: $75.00 9th - 12th grades: $95.00Applications must be accompanied by a registration fee. Tuition may be submitted at a later date, but must be submitted a minimum of two weeks before the start date.Tuition Options (1st - 8th Grades)When enrolling multiple students, if you would like to receive the multiple student discount, only submit the application(s) with registration. Do not include tuition. After submitting the application(s), call the office to submit the tuition. Option 1: Full Year $893. (1 installment) Option 2: Semester $496. (2 installments) Option 3: Quarterly $265. (4 installments) Not at this timeTuition Options (9th - 12th Grades)When enrolling multiple students, if you would like to receive the multiple student discount, only submit the application(s) with registration. Do not include tuition. After submitting the application(s), call the office to submit the tuition. Option 1: Full Year $994. (1 installment) Option 2: Semester $562. (2 installments) Option 3: Quarterly $293. (4 installments) Not at this timeTotal $0.00  : : : Parent / Supervisor Agreement  : : : : We have reviewed the Student Application 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. If enrolling from another school during a school year, we understand that the school year start date is the start date of the previous school and curriculum assignment adjustments will be made by the Academy staff. 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 will read and adhere to 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.Student's Signature*Father's / Guardian's Signature*Mother's / Guardian's Signature*Supervisor's Signature*Whoever will be supervising your student's daily work. Supervisor is responsible to read and follow the procedures in the Academy Handbook.Names and relationship of any and all persons who will be supervising this student:*Example: Diane Doe - Mother, Jane Doe - AuntIf so desired, list name(s) of those with whom student information may be shared:Please list the 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.).Program OnlineRegistration: (One Time Fee)* 3rd - 8th grades: $75.00 9th - 12th grades: $95.00Applications must be accompanied by a registration fee. Tuition may be submitted at a later date, but must be submitted a minimum of two weeks before the start date.Tuition Options (3rd - 8th Grades)When enrolling multiple students, if you would like to receive the multiple student discount, only submit the application(s) with registration. Do not include tuition. After submitting the application(s), call the office to submit the tuition. Option 1: Full Year $893. (1 installment) Option 2: Semester $496. (2 installments) Option 3: Quarterly $265. (4 installments) Option 4: Monthly $125. (9 installments) Not at this timeTuition Options (9th - 12th Grades)When enrolling multiple students, if you would like to receive the multiple student discount, only submit the application(s) with registration. Do not include tuition. After submitting the application(s), call the office to submit the tuition. Option 1: Full Year $994. (1 installment) Option 2: Semester $562. (2 installments) Option 3: Quarterly $293. (4 installments) Option 4: Monthly $135. (9 installments) Not at this timeTotal $0.00 Parent / Supervisor Agreement We have reviewed the Student Application 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. If enrolling from another school during a school year, we understand that the school year start date is the start date of the previous school and curriculum assignment adjustments will be made by the Academy staff. 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 will read and adhere to 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.Student's Signature*Father / Guardian Signature*Mother / Guardian Signature*Supervisor's Signature*Whoever will be supervising your student's daily work. Supervisor is responsible to read and follow the procedures in the Academy Handbook.Names and relationship of any and all persons who will be supervising this student:*Example: Diane Doe - Mother, Jane Doe - AuntIf so desired, list name(s) of those with whom student information may be shared:Please list the 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.).Payment DetailsThank you for completing the application. Please enter your payment information below. Applications will not be processed without payment.Student's Name* First Last HiddenDate* MM slash DD slash YYYY Total $0.00 To receive multiple student discount, do not include tuition. Submit application with registration only, then call the office to submit tuition.Credit Card*Card Details Cardholder NameΔ
Christian Academy Of America
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