CCGF Academy APPLICATION

Parent Information

Parent or Legal Guardian

Choose One

Father

Mother

Legal Guardian

If Legal Guardian state relation to the student

First Name

Last Name

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Phone Number

Birthdate

Occupation

Church Name

How long have you attended?

How did you hear about CCGF Academy?

Why would you like your student to attend CCGF Academy?

Are you currently a registered homeschool parent? Please specify.

Student #1 Information

First Name

Last Name

Birthdate

Gender

Grade Entering Into

Allergies

Health Issues / Learning Disabilities - Please identify any special concerns about which we should be aware.

Student #2 Information

First Name

Last Name

Birthdate

Gender

Grade Entering Into

Allergies

Health Issues / Learning Disabilities - Please identify any special concerns about which we should be aware.

Student #3 Information

First Name

Last Name

Birthdate

Gender

Grade Entering Into

Allergies

Health Issues / Learning Disabilities - Please identify any special concerns about which we should be aware.

Student #4 Information

First Name

Last Name

Birthdate

Gender

Grade Entering Into

Allergies

Health Issues / Learning Disabilities - Please identify any special concerns about which we should be aware.

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Contact us by phone (845) 915-3445 or email contact@ccgfacademy.org

CCGF Academy APPLICATION

Parent Information

Parent or Legal Guardian

Student #1 Information

Student #2 Information

Student #3 Information

Student #4 Information

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