Please use one Student Application Form for each child you are enrolling.
Student Information:   *
First Name * Student's
Middle Name Student's
Last Name *
Grade Completed* Current
Please enter any pertinent information concerning your child and his/her educational
Previous School Information:
City * State*
Date Attended (Approx.) *
American Indian or
Black or African American
Hispanic or Latino
Native Hawaiian or Pacific Islander
Enter N/A in any field for a
person that is not living in the home.
First Name* Father's
Father's Relation to Student*
First Name * Mother's
Mother's Relation to Student *
Marriage Status of Parents:*
**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 *
City* State * ZIP
Mailing Address *
City* State * ZIP
Home Phone* Cell Phone
* If none, type "None"
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?
indicate if you prefer online school, computer-based curriculum or workbook-style curriculum.
There are advantages to each and you may even combine
two. In any case, you may want to call and discuss the advantages
of either with one of our Education Specialists. Remember, there is an extra
cost for the computer-based curriculum and is only available in the
Full Year Payment option. The extra cost is an additional $15 per course
On-Line School (Requires reliable,
hi-speed, internet connection) (Grades 3 - 12 only)
Workbook-style for 1st and 2nd Grades
Workbook-style for 3rd - 12th Grades
Fee: (One Time Fee)..(Choose one)......................................
1. Kindergarten - 3rd grade: $35.00 or
2. 4th - 8th grade (Includes Diagnostic Testing & Placement): $50.00 or
3. 9th - 12th (9th & 10th includes Diagnostic Testing & Placement): $75.00
Tuition Fee: (See Registration & Fees for options)...................................
Total Fees (Add Registration & Tuition Fees).............................................
You may confidently e-mail this Application with your credit card information.
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:
* Security code
Name on Account
* ZIP Code
* Required Fields
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 further understand that some courses require
reference books, which are an extra cost. 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.
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 quarter 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 allow 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 that our child is to be under direct adult supervision during
study time and that the supervising adult has read and understands the
Academy procedures. We agree that the supervising adult will submit our
responses to the Academy's Required Response Forms that are sent to us via
email. We further understand that the supervising adult will require
that the student adhere to the Academy procedures, including, but not
exclusive of, copying answers from the Score Keys or Test Keys and by keeping
the Test Keys in a secure location. 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. 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 non-compliance of Academy procedures, and will be charged a
Reactivation Fee of $10.00.
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.
Father / Guardian Signature:
Mother / Guardian Signature:
Name of Parent, Guardian, or Supervisor responsible to administer
this home school program:
If this is a person other than the Parent or Guardian, please provide
the relationship to the student:
If desired, please list the names of any other relatives or non-family
persons and their relationship to the student, with whom the student's Academic
Advisor may discuss the student's academic information (tutors, grandparents,
noncustodial parent, etc.).