Little Cypress Christian Academy Application Form

INSPIRE. IMPACT. INVOLVE

Inspiring Leaders, Impacting Lives, Involving Families
Application For Enrollment
School Year *
Current Grade*
Does your child currently have an individualized education plan , receive 504 or other academic accommodations?*

YesNo
If yes, please explain below.

Student Enrollment Application
Steps in the Online Admission Process:

1. Complete this online application with the most accurate information.

2. Call to schedule your family interview and tour our academy.

3. Finalize enrollment for your family by completing the online registration form.

*SCHOLARS ARE ACCEPTED ONLY FOLLOWING THE FAMILY INTERVIEW PROCESS.
Student Admission Policy
LCCA admits students of any race, color, national, and ethic origin to all the rights, privileges, programs, and activities generally accorded or made available to students at the school. It does not discriminate on the basis of race, color, national and ethnic origin in the administration of its educational policies and school programs. Students are selected in order to maintain a student body of high academic and moral caliber. Admission is granted and vacancies are filled on the basis of academic achievement, prior performance in school, and other pertinent data. Only students who are in good standing with previous schools are accepted.
Student's Name*

First NameLast Name
Grade Applying For*
Let us know how you found out about LCCA! *
Sex*

MaleFemale
Age (yrs)*
Date of birth*

MonthDayYear
Student Address*

Street Address

Street Address Line 2

CityState

Postal Code
Parent / Guardian *

First NameLast Name
Relationship to student*
Primary Phone Number*
Secondary Phone Number*
Applicant's Education History
Current School*
School Phone Number*

What are your expectations for your child's education and overall experience at LCCA?*
I have read and understand the information in the LCCA Handbook linked on the academy website.*

Yes
I declare that all information provided is correct and understand that false, inaccurate or misleading information will result in the students’s withdrawal from school.*

Yes
Parent / Guardian *

First NameLast Name
Date

MonthDayYear
Date
Email*
example@example.com
My Products*
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New Scholar$20.00

Total $0.00
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Please click one of the PayPal options to complete payment and submit the form.
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INSPIRE. IMPACT. INVOLVE