Students & Families Articles Enrollment Enrollment Policy Apply Now Tuition & Payment School Policies FACTS Tuition Management Uniforms Summer Camps Apply Now If you would like a printable application to complete and mail in, please download the PDF. Child's Full Name Name your child prefers to be called Child's Date of Birth Class child is enrolling: K Thru 5th Grade: Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade K Thru 5th Grade Options 12 month program (261 days). Extended care included 9 month program (180 days) Extended care program (3:30 pm - 6:00 pm) Age 2 Thru Kindergarten Bridge 2 year old 3 year old 4 year old Kindergarten Bridge Age 2 Thru Kindergarten Bridge Options 12 month program (261 days). Extended care included 9 month program (180 days) Extended care program (3:30 pm - 6:00 pm) M, W, F T, Th My child will begin classes on this date Social Security Number Birth Certificate Number Family Information Father's Full Name Address City State Zip Employer Work Phone Mobile Phone Email Address Mother's Full Name Address City State Zip Employer Work Phone Mobile Phone Email Address Does your child have any food allergies, physical or emotional disabilities that may require special attention? Yes No If yes, please describe Emergency Information Name of person authorized to act for parent in emergency Address Phone Name of Physician Office Address Phone By checking this field, I authorize emergency medical care Other Information Child's Activities (hobbies, sports, other) Artistic / Musical interests or talents What language is spoken at home? Please indicate the number of hours each day spent watching or interacting with the following: Television On Weekends Movies/DVD On Weekends Computers On Weekends Video Games On Weekends If age appropriate alternatives were suggested, would you be willing to make changes in the way your child relates to media? Yes No Share with us any other information you feel we should know about your child or your family situation. (This information will be held in confidence.) What kind of experience do you hope to have at The Cedars Preparatory Academy? How did you learn of CPA? I certify that all information provided is complete and factually correct and that no substantive information has been omitted. Parent/Guardian Full Name
