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Thank you for your interest in Covenant Academy!

Please fill out the form below and our staff will contact you and provide the information you desire.

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Parent/Guardian Information
*First Parent/Guardian
Salutation *

First Name *

Middle Name

Last Name *
Email Address *
Cell Phone

(Ex: 999-999-9999)
Second Parent/Guardian
Salutation

First Name

Middle Name

Last Name
Email Address
Cell Phone

(Ex: 999-999-9999)
How Did You Hear About Covenant Academy? *

Details:
Home Phone *

(Ex: 999-999-9999)

The factors most influencing us to seek out information about Covenant Academy are: *

	Location		Dissatisfaction wtih current school
	Desire to attend private school		Academic reputation
	Christian Philosophy		Recommendation of CA families
	Classical teaching		Other

If you chose "Other," please explain.
Student 1
First Name *

Middle Name

Last Name *
Birthdate *

(mm/dd/yyyy)

Gender *

Male Female
Grade Level of Interest *

School Year *
Current School
Is There Another Student? Yes No
Parent/Guardian Notes