L&GCA Registration

Preschool Contract Enrollment Form

LOVE & Grace Christian Academy
All registrations are received and reviewed in a first come, first serve basis. Upon filling all open spots, all additional submissions will be added to our waiting list.
Preschool Registration
Expected Start Date

MonthDayYear
Expected Departure Date

MonthDayYear
Which class are you wanting to register for?*
Student Information
First Name*
Last Name*
Gender*

FemaleMale
Birth Date*

MonthDayYear
Home Phone*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Parent/Guardian Information 1
Full Name*

First NameLast Name
Home*

Area CodePhone Number
Cell

Area CodePhone Number
Work

Area CodePhone Number
E-mail*
Address - Same As Child*

YesNo
If your address is different than the childs please fill out the info below. Otherwise move onto the next section.
Parent/Guardian 1 Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Parent/Guardian Information 2
Full Name

First NameLast Name
Home

Area CodePhone Number
Work

Area CodePhone Number
Cell

Area CodePhone Number
E-mail
Address - Same As Childs

YesNo
If your address is different than the childs please fill out the info below. Otherwise move onto the next section.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Other Infomation
Would your child like to be in a class with a friend?

YesNo
Tell me somethings about your child that you think I should Know?
If yes, name and age of friend(s)?
Is there anything else you would like me to know about your child?
Will your child be able to set for 45 mins for a virtual learning class

YesNo
About Love & Grace Christian Academy

Virtual Learning Faith-Base Community
Welcome to Love & Grace Christian Academy! I am the founder of Love & Grace Christian Academy, and my name is Marquera Pitts. My objective is to support your child's growth and achievement so that they are prepared for kindergarten. Your child will be in a faith-based environment while attending Love & Grace, which means they will learn about and come to know Jesus Christ. After submitting your registration form, you will receive another email in 2 to 3 weeks with information on how courses will be conducted, what your child will require, and specifics on what else is included in the program. Thank you for deciding on Love & Grace Christian Academy, and I look forward to working with your child.

Thank you and have a bless day!

Ms. Marquera Pitts
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All registrations are received and reviewed in a first come, first serve basis. Upon filling all open spots, all additional submissions will be added to our waiting list.
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Preschool Contract Enrollment Form

Preschool Registration

Student Information

Parent/Guardian Information 1

Parent/Guardian Information 2

Other Infomation

About Love & Grace Christian Academy