Kimball Christian Academy Application

Kimball Christian Academy Application Form
Student Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Age
Email
example@example.com
Phone Number
Please enter a valid phone number.
Gender

MaleFemale
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Applying for Grade Level
School Last Attended
Previous School E-Mail
School Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian's Information
Parent/Guardian's Name - Primary

First NameLast Name
Occupation
Phone Number
Please enter a valid phone number.
Parent/Guardian's Name - Secondary

First NameLast Name
Occupation
Phone Number
Please enter a valid phone number.
Reminders
Entrance Requirements Upon Acceptance

The following is a checklist to help parents with the process of enrolling a child in Kimball Christian Academy. In addition to meeting the established admission requirements, these items are required for enrollment after official acceptance.
- Certified Birth Certificate
- Current Immunization Record
- Non-refundable Registration Fee of $200 due upon acceptance
- Any court documents
- Any specialized test results or placement in special programs including and IEP or Service Plan
- Transcript/Permanent School Record- will be requested by KCA following registration
- First tuition payment of $350 will be due August 1st, and upon the 1st of each month thereafter (Aug-May)
KCA shall not discriminate against any person on the basis of race, color, national or ethnic origin, sex, or age.
Date Signed

MonthDayYear
Date
Parent/Guardian Signature

Clear
Should be Empty:

Kimball Christian Academy Application Form

Parent/Guardian's Information

Reminders