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Application

Student Information

Child's Last Name*

Child's Middle Initial*

Child's First Name*

Age*

Gender*

Date of Birth*

Address*

Phone Number*

School District*

Family Information

Father's First & Last Name*

Employment*

Business Phone Number*

Mother's First & Last Name*

Employment*

Business Phone Number*

Marital Status*

Please list names and ages of other children in the home if any

Church Information

Church Attending*

Pastor*

Address*

Select all that apply*

Father is a born-again Christian believer

Mother is a born-again Christian believer

Student has made a profession of faith

Parents, please submit a brief testimony each.*

Parent Agreement

We are in agreement with the goals of Covenant Christian Academy. We promise and support the academic and disciplinary regulations and all other requirements as instituted by the Administration and carried out by the Director and Faculty.

We understand and pledge our commitment to make tuition payments on a regular basis according to the payment plan we have chosen.

Father E-Signature*

Mother E-Signature*

Scholastic Information

School last attended*

Address*

Reason for leaving*

References from previous school (principal and one teacher)*

Short answer*

Please provide a copy of the last report card.*

Please indicate the academic level of student's previous work.*

Excelent

Good

Average

Poor

Has the student ever been expelled, dismissed, suspended, or refused admission to another school?*

Yes

No

If so, please explain.

Has the student experienced discipline issues?*

Yes

No

If so, please explain.

Has the student ever used tobacco or drugs of any kind?*

Yes

No

If so, please explain.

Has the student ever been in trouble with the law or arrested, etc?*

Yes

No

If so, please explain.

Special needs, if any, of the student that you are expecting Covenant Christian Academy to accomodate

Student Self Evaluation

Please print and have the student complete this page, then attach it to this application.

https://2e627db6-d2cf-42ff-b4e6-2ef9433a36ad.usrfiles.com/ugd/2e627d_1784e3917a6d4c9fbafdfe12b33ed8d6.pdf

*

Registration

This application must be accompanied by the Registration and Testing fee of $100. This fee is non-refundable. Final enrollment is dependent on School Board approval.

Fixed price

$100

Covenant Christian
Academy

75 E. Union Blvd.

Bethlehem, PA 18018

Contact

ccadmin@ptd.net

(610) 868-7302
(610) 419-8008 (fax)

Connect With Us

First name*

Last name*

Email*

Subject*

Leave us a message!*

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