Chestnut Ridge Academy A Homeschool Umbrella

Chestnut Ridge Academy A Homeschool Umbrella

Please fill out the application form carefully
For all new registrations: before filling out this application, please be sure to download and read the Registration Policies found on the website.

If you were registered with Chestnut Ridge Academy for the 2019-20 school year, you may skip this part to complete your renewal application.
Student Information
Student Name *

First Name Last Name
School Year *
Birth Date *

Month Day Year
Student Grade Level *
Please check one: *

New Student to Chestnut Ridge Academy Renewal
If new to Chestnut Ridge Academy, how did you hear about us? When possible, give a name.
Primary Teacher's Name *
Must be a parent or legal guardian. This is the person who is taking responsibility for the child's education. This person may hire tutors or sign the child up for classes where he/she is taught by other individuals.
Parent Information
Mother's Name

First Name Last Name
Father's Name

First Name Last Name
E-mail *
Phone Number *

Area Code Phone Number
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
In what public school system does the student currently live? (For example: Lincoln County Schools, Fayetteville City Schools, etc) *
What is the name of the school the student currently attends? *

Parent Information