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Application

If you would like to request assistance with completing the application, or you would like to visit the school prior to applying, click here to schedule an appointment with CCA administration.

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

If so, please explain.

Has the student experienced discipline issues?*

Yes

If so, please explain.

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

Yes

If so, please explain.

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

Yes

If so, please explain.

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

Phone: (610) 868-7302
Fax: (610) 419-8008

75 E. Union Blvd.

Bethlehem, PA 18018

Connect With Us

First name*

Last name*

Email*

Leave us a message!*

Academic Excellence in a Christian Environment.

75 E Union Blvd. Bethlehem, PA 18018

(610) 868-7302

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