Form

Thank you for your interest in Jubilee Christian Preparatory Academy (JCPA)! Please note that submitting an application does not guarantee enrollment. This pre-screening application is the first step in determining your child’s eligibility for admission. Kindly read each question carefully and answer all sections relevant to your family. If you have already submitted an online application, please do not submit a duplicate. Doing so may cause system errors and delay the processing of your application. We’re excited to learn more about your child and your interest in JCPA!
Parent/Guardian

Please answer questions about education, employment and income based on the date of the application. For teen parents, only enter "Yes" if 19 years or younger on the date of application.
Name*

First NameMiddle NameLast Name
Birthday *

MonthDayYear
Date
Gender*
Email*

Confirmation EmailConfirm Email Address
Phone Number*
Please enter a valid phone number.
Opt In for Text Messages
Home Phone
Please enter a valid phone number.
Work Phone
Please enter a valid phone number.
Ext.
Race*
Hispanic*
Lives with Family*
Highest Grade Completed*
Employment Status*
Child's Relationship*
Custody*
Provides Financial Support*
Teen Parent*
How did you hear about us*
Address
You must provide your current address. Sheltering Arms cannot accept a P.O. Box as your living address.
Is your family experiencing homelessness?*
Street Address

Address Line 2

CityState

Zip Code
Other Adults
Are there other adults in the household?
Name*

First NameLast Name
Birthday *

MonthDayYear
Date
Gender*
Email*

Confirmation EmailConfirm Email Address
Phone Number*
Please enter a valid phone number.
Opt In for Text Messages
Home Phone*
Please enter a valid phone number.
Work Phone
Please enter a valid phone number.
Ext.
Race*
Hispanic*
Lives with Family*
Highest Grade Completed*
Employment Status*
Child's Relationship*
Custody*
Provides Financial Support*
Teen Parent*
Relationship To Parents/Guardians*
Supported by Parents/Guardians*
Family Information

For number in family: Sheltering Arms defines family as all persons living in the same household who are supported by the child’s parent(s)’ or guardian(s)’ income; and are related to the child’s parent(s) or guardian(s) by blood, marriage, or adoption; or are the child’s authorized care giver or legally responsible party. Please answer "Yes" for TANF, SNAP and WIC if you are currently receiving these benefits. Example: Mother lives with father (blood, marriage, adoption, or legal guardian) and they both provide financial support for three children. The number in the family is five.
Number of Parents/Guardians*
Relationship to Participant(s)*
Number in Family*
Is your family receiving cash benefits or other services under the Temporary Assistance for Needy Families (TANF) program?*
Is your family receiving Supplemental Security Income (SSI)?*
Is your family receiving services from WIC?*
Is your family receiving services under the Supplemental Nutrition Assistance Program (SNAP), formerly referred to as Food Stamps?*
Is at least one parent/guardian an active duty member of the United States military?*
Is at least one parent/guardian a veteran of the United States military?*
Emergency Contacts
Add Emergency Contact*
Name*

First NameLast Name
Relationship*
May we contact this person if we are unable to reach you?*
May we release your child to this person?*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mobile Phone*
Please enter a valid phone number.
Home Phone*
Please enter a valid phone number.
Work Phone
Please enter a valid phone number.
Ext.
Child (Applicant)

If your child has an IEP or IFSP, chronic condition like asthma, diabetes, seizures, allergies, dietary restrictions please enter the details in the notes at the end of the application and upload supporting documents in the upload attachments section.
Name*

First NameMiddle NameLast Name
SuffixNickname
Birthday *

MonthDayYear
Date
Gender*
Race*
Hispanic*
Primary Health Coverage*
Other Coverage*
Medicaid Eligibility*
Doctor/Medical Home*
Dental Coverage*
Dentist/Dental Home*
Does your child have a disability or do you have any concerns about your child's development?*
Is there anything else you want to tell us about your child?
Before/After School Care*
Step Into Learning – Choose a Grade

Select your child’s grade level as they grow in faith and knowledge at JCPA
Which program are you applying for?*
Should be Empty:

Parent/Guardian

Address

Other Adults

Family Information

Emergency Contacts

Child (Applicant)

Step Into Learning – Choose a Grade