Request Information
Thank you for your interest in Liberty Baptist Academy! Please fill out the form below and the school office will contact you within 2 business days.
Parent/Guardian Information
First Parent/Guardian
*
First Name
Last Name
Gender
*
Male
Female
Email Address
*
example@example.com
Cell Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Home Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Second Parent/Guardian
*
First Name
Last Name
Gender
*
Male
Female
Is the second parent/guardian's contact information different than the first parent/guardian?
*
Yes
No
Email Address
*
example@example.com
Cell Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Home Phone
Please enter a valid phone number.
Format: (000) 000-0000.
How did you hear about us?
*
Current Student
Current Student/Parent
Faculty/Teacher
Former Parent(s)
Internet/Website
Neighbor
Pastor
Social Media
Word of Mouth
Do you have a church home? If so, what is the name of the church?
*
If no, type "none"
Student Information
Student Information
*
Parent/Guardian Notes
Submit
Should be Empty: