Private - Central Arkansas Christian Schools

Application for Admission

Applicant Name*

First Middle Last

Year of Proposed Entrance*

Semester*

Preferred Campus*

Applying for Grade (Secondary)*

Applying for Grade (NLR and PV)*

Applying for Grade (MM Elem)*

PreK Options*

Choose the length of school day you prefer for your PreK student. The Core Program runs from 8 a.m. to 11:45 a.m., while the Extended Program runs from 8 a.m.-3 p.m.

PreK Number of Days*

How many days per week will your child attend. Choose between two, three and five days.

Applicant Information

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Social Security Number*

Date of Birth*

Age*

Sex*

Male

Female

Applicant Current Grade*

Applicant Current School*

Family Information

Parent/Guardian #1 Name

First Last

Relation to Applicant*

Notes:

Different Home Address?

Parent/Guardian #1 has a different home address than applicant

Parent/Guardian #2 Home Address (if different from applicant's)*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email Address*

Cell Phone Number*

Employer*

Job Title*

Business Phone*

Parent/Guardian #2 Name

First Last

Relation to Applicant

Notes:

Different Home Address?

Parent/Guardian #2 has a different home address than applicant

Parent/Guardian #2 Home Address (if different from applicant's)*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email Address

Cell Phone Number

Employer

Job Title

Business Phone

Check if appropriate:

Father Deceased

Mother Deceased

Parents Divorced

Parents Seperated

Father Remarried

Mother Remarried

If parents are divorced or separated, who has legal custody of applicant?

Applicant Education

Name of Current School*

Dates of Attendance*

Address of Current School*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

School Contact Person*

Phone*

Previous School(s) Name(s)

Previous School(s) Location(s)

Previous School(s) Dates of Attendance

Are you interested in applying for our Foundations Program, designed to address the educational needs of students in grades 6-12 with the primary diagnosis of dyslexia or other language-based learning differences?*

Siblings

1. Name

First Last

Relationship

Age

Grade

Attend(ed) CAC

Applying to CAC

2. Name

First Last

Relationship

Age

Grade

Attend(ed) CAC

Applying to CAC

3. Name

First Last

Relationship

Age

Grade

Attend(ed) CAC

Applying to CAC

4. Name

First Last

Relationship

Age

Grade

Attend(ed) CAC

Applying to CAC

Notes

Emergency Contacts

Primary Emergency Contact*

First Last

Relationship to Student*

Phone*

Secondary Emergency Contact*

First Last

Relationship to Student*

Phone*

Optional Information

Religious Affiliation

Name of Church

Ethnic Background

African American

Asian American

Caucasian

Hispanic/Latino

Middle Eastern

Mixed Race

Native American

Other

How did you hear about CAC?

If someone recommended CAC to your family, please take a moment to list their name here.

Copy of Current Report Card

Max. file size: 64 MB.

Notes:

Number

Application Fee

Price:

Billing Address*

Street Address Address Line 2 City State ZIP Code

Credit Card*

Card Details

Cardholder Name

Name

This field is for validation purposes and should be left unchanged.

Quick Links:

Apply Online

Application for Admission

Applicant Information

Family Information

Applicant Education

Siblings

Emergency Contacts

Optional Information

Application Fee