Collierville Classical School 2024 K-12 Application

Collierville Classical School K-12 Application

Kindergarten applicants must be five as of August 31, and fully potty trained.
We are delighted that you are interested in our classical Christian homeschool tutorial. Our program is designed to provide a well-rounded, academically rigorous education grounded in the Christian faith. We partner with parents to equip their students to navigate the world's challenges with a strong moral compass. Our dedicated team of instructors is passionate about teaching and committed to nurturing each student's academic, spiritual, and personal growth. We believe this partnership with parents in their homeschool journey will allow the benefits of Christian homeschooling to extend beyond academics and provide a unique and enriching educational experience for both children and parents alike.

Application and Enrollment Process:

Step 1 – Complete an online application and pay the $50.00 non-refundable application fee per child.

Step 2 – If needed, a records release form will be emailed to you. Please follow instructions and submit when completed. A contract cannot be issued until this step is completed and reviewed.

Step 3 – The student’s file is reviewed by admissions and parents will be contacted regarding a decision.

Step 4 –If the application is approved, a contract will be issued and will need to be signed by both parties.

We are excited to embark on this journey with you and your family and look forward to seeing the growth and success of your child in our program. Thank you for choosing our classical Christian homeschool tutorial.
* There is a $50 non-refundable application fee per student. At the end of the application form, you will be asked to provide your credit card information. Please have your credit card information available to complete the application process.

** If your child was enrolled in another school, you will need to fill out information and an Authorization for Release of School Records for each student. For example, if applying for three students, you will be asked to fill out three authorizations on this form. Homeschool students will not need to complete this step.

*** À la carte students are not eligible for our Founder's Discount on tuition or for the application fee to be credited towards tuition

How many students do you want to apply for?*
Your name:*

First NameLast Name
What is your relationship with the student(s)?*
Email*
example@example.com
Phone number*
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Would you consider yourself to be a professing Christian?*
Please share your testimony in three parts. 1. How would you describe yourself before Christ? *
2. When did you hear the gospel and come to believe it? *
3. Since then, what has life looked like as a follower of Jesus? *
What Church do you attend?*
If one or more of the following questions do not apply to you and the student(s) you are applying for, please leave the fields blank.

If you have already filled out the following information on the previous page or if no questions apply to you, you may continue to the next page.
Mother's Email
example@example.com
Mother's Name

First NameLast Name
Mother's Phone Number
Please enter a valid phone number.
Mother's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mother's Employer
Father's Name

First NameLast Name
Father's Phone Number
Please enter a valid phone number.
Father's Email
example@example.com
Father's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Father's Employer

STUDENT'S INFORMATION | AUTHORIZATION FOR RELEASE OF SCHOOL STUDENT RECORDS

Please fill out the information below with your information, the student's information, and the name of the school/institution from which we will need to request a copy of records.
Student's name*

First NameLast Name
Student's preferred name (leave blank if same as previous question)

First NameLast Name
Student's date of birth*

MonthDayYear
Date
Grade (for 2024-25)?*
Gender?*

MaleFemale
Are you applying for full enrollment or à la carte?*

Full EnrollmentÀ la carte
What was your child's previous educational model?*
Length of time enrolled in last school? *
List any medical conditions and/or allergies:
List any special needs:
Child resides with:*
Responsible party for payments:*
Please provide a brief evaluation of your child's academic background and achievement.
Are there any academic concerns, mental, or social issues present in your student (ex: ADHD, dyslexia).
Note: undisclosed academic, social, mental, or behavioral issues may result in immediate dismissal from the program.
I, First Name* Last Name* , * authorize

Name of school/institution/agency* to release the records marked below, for inspection

and/or copying by, and/or communicate with, the recipient(s) noted below,

regarding Student First Name* Student Last Name* Student's Birthdate* .
Recipient(s): Lisa Strasko, Head of School
Collierville Classical School
2005 E. Winchester Blvd
Collierville, TN, 38017

901-255-8133
AUTHORIZATION FOR RELEASE OF SCHOOL STUDENT RECORD

This consent is valid for one year from the authorized signature date, unless otherwise revoked by me in writing.
1. Information may be disclosed/obtained by: Mail, In-Person, Phone, or E-mail.
2. This consent is valid for a period of one year. I understand that I have a right to revoke this authorization at any time except to the extent that the program or person who is to make the disclosure has already acted in reliance on it. Any revocation must be in writing and must be sent/given to the school's Records Custodian. Furthermore, I understand that no revocation shall prevent the disclosure of records and communications until it is received by the person authorized to disclose records and communications.
3. I further release Collierville Classical School from all liability and claims pertaining to or arising from the disclosure of the information requested.
RECORDS TO BE RELEASED
Parent or Legal Guardian:
Fill in the date of attendance from the previous school/institution: Start Date to End Date*

Information/Records to be released:
- Student’s Name, Address, DOB
- Parent’s Name(s), Address(es)
- Academic Records, Medical Records, Behavioral and Disciplinary Records
- Test Scores: intelligence, aptitude, achievement levels
- Special Education Records: IEP, Psychological Evaluations, Social Work Assessment
- Other: Specialized Evaluations: psychiatric, audiological, vocational assessment
Reports/Evaluations Received from:*
Your Signature*

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Today's Date*

MonthDayYear
Date

SECOND STUDENT'S INFORMATION | AUTHORIZATION FOR RELEASE OF SCHOOL STUDENT RECORDS

Please fill out the information below with your information, the student's information, and the name of the school/institution from which we will need to request a copy of records.
Student's name*

First NameLast Name
Student's preferred name (leave blank if same as previous question)

First NameLast Name
Student's date of birth*

MonthDayYear
Date
Grade (for 2024-25)?*
Gender?*

MaleFemale
Are you applying for full enrollment or à la carte?*

Full EnrollmentÀ la carte
What was your child's previous educational model?*
Length of time enrolled in last school? *
List any medical conditions and/or allergies:
List any special needs:
Child resides with:*
Responsible party for payments:*
Please provide a brief evaluation of your child's academic background and achievement.
Are there any academic concerns, mental, or social issues present in your student (ex: ADHD, dyslexia).
Note: undisclosed academic, social, mental, or behavioral issues may result in immediate dismissal from the program.
I,First Name*   Last Name*   ,  * authorize

school/institution/* to release the records

marked below, for inspection and/or copying by, and/or communicate with, the

recipient(s) noted below, regardingStudent First NameStudent Last Name

Student's Date of Birth* .
Recipient(s): Lisa Strasko, Head of School
Collierville Classical School
2005 E. Winchester Blvd
Collierville, TN, 38017

tel: 901-255-8133
AUTHORIZATION FOR RELEASE OF SCHOOL STUDENT RECORD

This consent is valid for one year from the authorized signature date, unless otherwise revoked by me in writing.
1. Information may be disclosed/obtained by: Mail, In-Person, Phone, or E-mail.
2. This consent is valid for a period of one year. I understand that I have a right to revoke this authorization at any time except to the extent that the program or person who is to make the disclosure has already acted in reliance on it. Any revocation must be in writing and must be sent/given to the school's Records Custodian. Furthermore, I understand that no revocation shall prevent the disclosure of records and communications until it is received by the person authorized to disclose records and communications.
3. I further release Collierville Classical School from all liability and claims pertaining to or arising from the disclosure of the information requested.
RECORDS TO BE RELEASED
Parent or Legal Guardian:
Fill in the date of attendance from the previous school/institution: Start Date* to End Date*

Information/Records to be released:
- Student’s Name, Address, DOB
- Parent’s Name(s), Address(es)
- Academic Records, Medical Records, Behavioral and Disciplinary Records
- Test Scores: intelligence, aptitude, achievement levels
- Special Education Records: IEP, Psychological Evaluations, Social Work Assessment
- Other: Specialized Evaluations: psychiatric, audiological, vocational assessment
Reports/Evaluations Received from:*
Your Signature*

Powered by Jotform SignClear
Today's Date*

MonthDayYear
Date

THIRD STUDENT'S INFORMATION | AUTHORIZATION FOR RELEASE OF SCHOOL STUDENT RECORDS

Please fill out the information below with your information, the student's information, and the name of the school/institution from which we will need to request a copy of records.
Student's name*

First NameLast Name
Student's preferred name (leave blank if same as previous question)

First NameLast Name
Student's date of birth*

MonthDayYear
Date
Grade (for 2024-25)?*
Gender?*

MaleFemale
Are you applying for full enrollment or à la carte?*

Full EnrollmentÀ la carte
What was your child's previous educational model?*
Length of time enrolled in last school? *
List any medical conditions and/or allergies:
List any special needs:
Child resides with:*
Responsible party for payments:*
Please provide a brief evaluation of your child's academic background and achievement.
Are there any academic concerns, mental, or social issues present in your student (ex: ADHD, dyslexia).
Note: undisclosed academic, social, mental, or behavioral issues may result in immediate dismissal from the program.
I, First Name* Last Name* , * authorize

name of school/institution/agency* to release the records marked below, for

inspection and/or copying by, and/or communicate with, the recipient(s) noted below,

regarding Student First Name Student Last Name

Student's DOB* .
Recipient(s): Lisa Strasko, Head of School
Collierville Classical School
2005 E. Winchester Blvd
Collierville, TN, 38017

tel: 901-255-8133
AUTHORIZATION FOR RELEASE OF SCHOOL STUDENT RECORD

This consent is valid for one year from the authorized signature date, unless otherwise revoked by me in writing.
1. Information may be disclosed/obtained by: Mail, In-Person, Phone, or E-mail.
2. This consent is valid for a period of one year. I understand that I have a right to revoke this authorization at any time except to the extent that the program or person who is to make the disclosure has already acted in reliance on it. Any revocation must be in writing and must be sent/given to the school's Records Custodian. Furthermore, I understand that no revocation shall prevent the disclosure of records and communications until it is received by the person authorized to disclose records and communications.
3. I further release Collierville Classical School from all liability and claims pertaining to or arising from the disclosure of the information requested.
RECORDS TO BE RELEASED
Parent or Legal Guardian:
Fill in the date of attendance from the previous school/institution: Start Date* to End Date*

Information/Records to be released:
- Student’s Name, Address, DOB
- Parent’s Name(s), Address(es)
- Academic Records, Medical Records, Behavioral and Disciplinary Records
- Test Scores: intelligence, aptitude, achievement levels
- Special Education Records: IEP, Psychological Evaluations, Social Work Assessment
- Other: Specialized Evaluations: psychiatric, audiological, vocational assessment
Reports/Evaluations Received from:*
Your Signature*

Powered by Jotform SignClear
Today's Date*

MonthDayYear
Date

FOURTH STUDENT'S INFORMATION | AUTHORIZATION FOR RELEASE OF SCHOOL STUDENT RECORDS

Please fill out the information below with your information, the student's information, and the name of the school/institution from which we will need to request a copy of records.
Student's name*

First NameLast Name
Student's preferred name (leave blank if same as previous question)

First NameLast Name
Student's date of birth*

MonthDayYear
Date
Grade (for 2024-25)?*
Gender?*

MaleFemale
Are you applying for full enrollment or à la carte?*

Full EnrollmentÀ la carte
What was your child's previous educational model?*
Length of time enrolled in last school? *
List any medical conditions and/or allergies:
List any special needs:
Child resides with:*
Responsible party for payments:*
Please provide a brief evaluation of your child's academic background and achievement.
Are there any academic concerns, mental, or social issues present in your student (ex: ADHD, dyslexia).
Note: undisclosed academic, social, mental, or behavioral issues may result in immediate dismissal from the program.
I, First Name* Last Name* , * authorizeNAME OF INSTITUTION/SCHOOL/SCHOOL DISTRICT* to release the records marked below, for inspection and/or copying by, and/or communicate with, the recipient(s) noted below, regardingStudent's Last Name, First Name, Initial * Student's DOB* .
Recipient(s): Lisa Strasko, Head of School
Collierville Classical School
2005 E. Winchester Blvd
Collierville, TN, 38017

tel: 901-255-8133
AUTHORIZATION FOR RELEASE OF SCHOOL STUDENT RECORD

This consent is valid for one year from the authorized signature date, unless otherwise revoked by me in writing.
1. Information may be disclosed/obtained by: Mail, In-Person, Phone, or E-mail.
2. This consent is valid for a period of one year. I understand that I have a right to revoke this authorization at any time except to the extent that the program or person who is to make the disclosure has already acted in reliance on it. Any revocation must be in writing and must be sent/given to the school's Records Custodian. Furthermore, I understand that no revocation shall prevent the disclosure of records and communications until it is received by the person authorized to disclose records and communications.
3. I further release Collierville Classical School from all liability and claims pertaining to or arising from the disclosure of the information requested.
RECORDS TO BE RELEASED
Parent or Legal Guardian:
Fill in the date of attendance from the previous school/institution: Start Date* to End Date*

Information/Records to be released:
- Student’s Name, Address, DOB
- Parent’s Name(s), Address(es)
- Academic Records, Medical Records, Behavioral and Disciplinary Records
- Test Scores: intelligence, aptitude, achievement levels
- Special Education Records: IEP, Psychological Evaluations, Social Work Assessment
- Other: Specialized Evaluations: psychiatric, audiological, vocational assessment
Reports/Evaluations Received from:*
Your Signature*

Powered by Jotform SignClear
Today's Date*

MonthDayYear
Date

FIFTH STUDENT'S INFORMATION | AUTHORIZATION FOR RELEASE OF SCHOOL STUDENT RECORDS

Please fill out the information below with your information, the student's information, and the name of the school/institution from which we will need to request a copy of records.
Student's name*

First NameLast Name
Student's preferred name (leave blank if same as previous question)

First NameLast Name
Student's date of birth*

MonthDayYear
Date
Grade (for 2024-25)?*
Gender?*

MaleFemale
Are you applying for full enrollment or à la carte?*

Full EnrollmentÀ la carte
What was your child's previous educational model?*
Length of time enrolled in last school? *
List any medical conditions and/or allergies:
List any special needs:
Child resides with:*
Responsible party for payments:*
Please provide a brief evaluation of your child's academic background and achievement.
Are there any academic concerns, mental, or social issues present in your student (ex: ADHD, dyslexia).
Note: undisclosed academic, social, mental, or behavioral issues may result in immediate dismissal from the program.
I, First Name* Last Name* , * authorize

name of school/institution/agency* to release the records

marked below, for inspection and/or copying by, and/or communicate with, the

recipient(s) noted below, regarding Student's First NameStudent's Last Name

Student's Date of Birth* .
Recipient(s): Lisa Strasko, Head of School
Collierville Classical School
2005 E. Winchester Blvd
Collierville, TN, 38017

tel: 901-255-8133
AUTHORIZATION FOR RELEASE OF SCHOOL STUDENT RECORD

This consent is valid for one year from the authorized signature date, unless otherwise revoked by me in writing.
1. Information may be disclosed/obtained by: Mail, In-Person, Phone, or E-mail.
2. This consent is valid for a period of one year. I understand that I have a right to revoke this authorization at any time except to the extent that the program or person who is to make the disclosure has already acted in reliance on it. Any revocation must be in writing and must be sent/given to the school's Records Custodian. Furthermore, I understand that no revocation shall prevent the disclosure of records and communications until it is received by the person authorized to disclose records and communications.
3. I further release Collierville Classical School from all liability and claims pertaining to or arising from the disclosure of the information requested.
RECORDS TO BE RELEASED
Parent or Legal Guardian:
Fill in the date of attendance from the previous school/institution: Start Date* to End Date*

Information/Records to be released:
- Student’s Name, Address, DOB
- Parent’s Name(s), Address(es)
- Academic Records, Medical Records, Behavioral and Disciplinary Records
- Test Scores: intelligence, aptitude, achievement levels
- Special Education Records: IEP, Psychological Evaluations, Social Work Assessment
- Other: Specialized Evaluations: psychiatric, audiological, vocational assessment
Reports/Evaluations Received from:*
Your Signature*

Powered by Jotform SignClear
Today's Date*

MonthDayYear
Date

In the "quantity" section, please choose the total number of students you are applying for.

Please note:
- The Founder's Discount is limited to the first 30 students who apply.
  - The Founder's Discount will not be a selectable option once all 30 slots are taken.
  - If you cannot complete registration for your entire family due to the limited number of Founder's Discounts, please choose as many Founder's Discounts as available and the standard discount for everyone else. For example, if only two Founder's slots are left but you have three children, two of your children would be eligible for the discount, and the third would receive the standard tuition rate.
  - If you cannot complete enrollment, the Founder's Discount will transfer to another family.
  - As a reminder, à la carte students are not eligible for the Founder's Discount on tuition.
- If you complete the enrollment process, the $50 non-refundable application fee and the Founder's Discount will be credited towards your tuition. Credit is not applicable towards a la carte classes.

Application Fee Payment*

Founder's ApplicationIn the "quantity" section, please choose the total number of students you are applying for. If you are unable to complete enrollment, the Founder's Discount will transfer to another family. If you complete the enrollment process, the $50 application fee and the Founder's discount will be credited towards your tuition. The Founder's Application is limited to the first 30 students who apply.

$50.00 Quantity
Item subtotal:$0.00

Standard ApplicationIn the "quantity" section, please choose the number of students you are applying for. This is our standard application for CSS. It is $50 per student you are enrolling. If you complete the enrollment process, the $50 will be credited towards your tuition.

$50.00 Quantity
Item subtotal:$0.00

Enter coupon

Total

$0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

The box with "12345" is for your zip code.

Once you hit submit, you will receive an email with your application and an invoice for the credit card charge.

Should be Empty:

Collierville Classical School K-12 Application

STUDENT'S INFORMATION | AUTHORIZATION FOR RELEASE OF SCHOOL STUDENT RECORDS

RECORDS TO BE RELEASED

SECOND STUDENT'S INFORMATION | AUTHORIZATION FOR RELEASE OF SCHOOL STUDENT RECORDS

RECORDS TO BE RELEASED

THIRD STUDENT'S INFORMATION | AUTHORIZATION FOR RELEASE OF SCHOOL STUDENT RECORDS

RECORDS TO BE RELEASED

FOURTH STUDENT'S INFORMATION | AUTHORIZATION FOR RELEASE OF SCHOOL STUDENT RECORDS

RECORDS TO BE RELEASED

FIFTH STUDENT'S INFORMATION | AUTHORIZATION FOR RELEASE OF SCHOOL STUDENT RECORDS

RECORDS TO BE RELEASED