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 *
If student is registering as a 12th grade student, does he/she plan to walk in the spring graduation ceremony? (There is no requirement to walk in the graduation ceremony to receive a diploma. The ceremony is something CRA offers every spring. Students may graduate at any time during the year and still be eligible to walk in the ceremony. For more details, contact the main office.) *

Yes, my child plans to walk. No, my child will not walk. Undecided at this time. My child is not a 12th grade student.
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.
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
Primary Teacher's Name *
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.
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

Payment information
Student Fee (Do NOT include graduating senior fee)
Graduation Fee (for high school seniors only)
Total Amount Owed
You may pay the Total Amount Owed by sending a check or money order to: Chestnut Ridge Academy, PO Box 49, Fayetteville, TN 37334. You may also pay cash in person or use your credit or debit card below. Please keep all receipts of payment in a safe place.

Registration Fees by Debit or Credit Card

USD Please enter the amount from the Total Amount Owed box above. If you are not sure how much is owed, please call Chestnut Ridge Academy at (931)227-7391)

Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Date	Postal Code

DateTime
Should be Empty:

Chestnut Ridge Academy A Homeschool Umbrella

Student Information

Parent Information

Background Information

Payment information