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Request Information

Thank you for your interest in our school!

Please fill out the form below and our Admissions Office will contact you and provide the information you desire.  

As you consider Concord Christian Academy for your student, please be aware that CCA does not have a Special Ed Dept. and in most cases is not equipped to support a special education plan for students who require direct intervention or supports. We have limited specialists available in the area of English and Language Arts and they are available to our enrolled families for an additional cost above the published tuition rates. 

* Indicates a required field.

Parent / Guardian Information
  • First Parent / Guardian
  • First Name *
  • Middle Name
  • Last Name *
  • Salutation *
  • Email Address *
  • Confirm Email Address *
  • Gender *
  • Work Phone
  • Cell Phone
  • Second Parent / Guardian
    (leave blank if not applicable)
  • First Name *
  • Middle Name
  • Last Name *
  • Salutation *
  • Email Address *
  • Confirm Email Address *
  • Gender *
  • Work Phone
  • Cell Phone
Home Address
  • Street Address *
  • City *
  • Country *
  • State
    *
  • Zip
    *
  • Home Phone *
  • How did you hear about Concord Christian Academy? *
    Details:

  • Is the student you are inquiring for related to you biologically or adopted?  Please answer in the box below.
    *

  • Does the students parent/parents work?  If so, please tell us where you work.
    *

  • Please tell us what church you currently attend?
    If you do not regularly attend a local church please simply respond by typing "Do not attend".
    *

  • Areas of interest (check all that apply):
    *

  • Marital Status
    *

  • If you choose to attend Concord Christian Academy, will you be filling out a financial aid application?
    * Yes   No

  • Is there any family history (parental or sibling) with a learning challenge or disability?  This could include Dyslexia, Dysgraphia, Executive Functioning Issues, ADD, ADHD, Reading or Comprehension Difficulty, etc.). Please answer accordingly below.
    *

  • Has the student ever been held back at a grade level?  If YES, what grade was repeated and why?
    *

  • Is there any ongoing or anticipated school district testing (academic or behavioral) in process?  Please explain below.
    *

  • Is there any known family history of trauma related incidents that are affecting or may affect your student's academic or social progress. Please explain below.
    *

  • Does your student have a current IEP or 504 Plan in place or is there a plan to request an IEP or 504 Plan for your student?
    Please answer Yes or No in the box below and provide additional information regarding the type of plan in place for your student.
    *

  • Has your student ever been involved in any behavior incidents at their past or current schools?  Please explain best you can.

     
    *

  • Has your student ever been bullied or been involved in a bullying situation?  Please explain.
    *

  • Briefly explain your students academic progress along with their strengths and challenges.
    *

  • Please tell us if your student has ever been suspended from school?  Please explain the details related to the suspension.
    *
  •  
  • Student 1
  • First Name *
    Middle Name *
    Last Name *
  • Birthdate *
    (mm/dd/yyyy)
    Gender *
  • Email Address
    Confirm Email Address
  • Grade Level of Interest *
    School Year *
  • Student Interests
    Student Interests
  • Current School

  • If Other is chosen for Student Interests, please specify.

  • What is your preferred method of communication?
    *

  • Please check any diagnosis that your student currently has or is being tested for?
    Please check all that apply.
    *

  • School attendance is a vital part of a students successful learning experience.  Please be advised that we will review your students transcript from any previous schools to verify that attendance is in good standing.  
    Does your student regularly attend school and arrive on time?
    Please answer Yes or No and give an explanation if necessary.
    *

  • Is your student(s) aware of the plans to inquire about admissions and possible enrollment at CCA?
    * Yes   No

  • Is your student(s) in support of enrollment at CCA?
    Please check all that apply.
    *
  •  
  • Is There Another Student?
    Yes No
  •  
  • Parent / Guardian Notes
  •