Chesterton Interest Form

Chesterton Academy Interest Form
Greetings! We are conducting an interest survey as we work towards establishing a Chesterton Academy in Southwest Louisiana, a new independent, classical high school to serve families in the Southwest Louisiana area. Your responses will help us understand our future community. Rest assured that your answers will remain confidential and will only be used for the purpose stated above. Please provide only one response per household. Thank you for your time.
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Husband's Occupation
Wife's Occupation
1. How many children are in your family?

2. Please list First Name, Grade, Sex, and Current School of your child/children.

3. Would you be interested in enrolling your child/children for Chesterton Academy's 2025 opening?

YesNo
4. If yes, how many children and in which grades do you seek enrollment?

Grade 9 Grade 10

Number of Children Fall 2025
5. If you have younger students, what is the likelihood you would consider sending them to Chesterton Academy in the future?

1

2

3

4

5

1 is Not Likely, 5 is Very Likely
6. If you do not send your students to Chesterton Academy for high school, where are you most likely to send them?

Home SchoolCatholic School - DiocesanCatholic - IndependentPublicIndependent/PrivateVocationalOther
7. Names of other high schools under consideration:
8. Please indicate how much tuition you would be willing/able to invest annually in high school education for your student. (both amount per student and maximum per family)
9. How far (in miles) would you be willing to drive each way to school?
10. What 3 towns would be ideal for Chesterton Academy's location?

	Grade 9	Grade 10
Number of Children Fall 2025

11. For the following fourteen different aspects of Chesterton Academy, please identify how important each item is to you.

	Not at all important	Low Importance	Neutral	Important	Very Important
Daily Mass
Sports
Extracurricular Clubs
Location
High Academic Standards
Virtue Formation
Disciplined Environment
Teacher/Student Ratio
Teachers and Administration Oath of Fidelity to the Magisterium
Classical Curriculum
Catholic Identity
Diocesan Recognition
Affordable
Learning Support/Special Education Services

12. What sports are your students are interested in? (List top three choices.)
13. What clubs would your future students be interested in? (List top three choices.)
14. Do you belong to a parish?

YesNo
If yes, what is the name of the Parish?
16. Are there any additional comments, thoughts or ideas you would like to share?
Thank you so much for taking the time to fill out this survey and for helping us determine the requirements for our Chesterton Academy! Please keep this initiative in your prayers! God bless you and your family.
Should be Empty:

Chesterton Academy Interest Form