Skip Navigation

Request Information

Thank you for your interest in Covenant Christian Academy.

Please complete the information below, and our Director of Admissions will be in touch.

* Indicates a required field.

Parent / Guardian Information
  • First Parent / Guardian
  • Last Name *
  • First Name *
  • Salutation *
  • Email Address *
  • Gender *
  • Cell Phone
    (Ex: 999-999-9999)
  • Second Parent / Guardian
    (leave blank if not applicable)
  • Last Name *
  • First Name *
  • Salutation *
  • Email Address *
  • Gender *
  • Cell Phone
    (Ex: 999-999-9999)
Home Address
  • Street Address *
  • City *
  • Country *
  • State *
  • Zip *
  • Home Phone
    (Ex: 999-999-9999)
  • How Did You Hear About Us?
    Details:
  • How did you hear about Covenant Christian Academy?

    *
  •  
  • Student 1
  • First Name *
    Last Name *
  • Gender *
  • Grade Level of Interest *
    School Year *
  • Student Interests
  • Current School
  • How can we help you today?

    *
  •  
  • Is There Another Student?
    Yes No
  •  
  • Parent / Guardian Notes
  •