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Request Tour and Information

Thank you for your interest in City Church Academy! 

Please fill out the form below to request more information.


* Indicates a required field.

Parent / Guardian Information
  • First Parent / Guardian
  • First Name *
  • Last Name *
  • Salutation *
  • Email Address *
  • Confirm Email Address *
  • Gender *
  • Cell Phone *
Home Address
  • Street Address *
  • City *
  • Country *
  • State
    *
  • Zip
    *
  • How Did You Hear About Us? *
    Details:

  • Is there a discipline record to share?
    * Yes   No

  • Does your child have an IEP, 504 plan, or other learning plan to share?
    * Yes   No

  • Do you attend a local church in our community?
    * Yes   No

  • What is the name of the church?
    *

  • Which Step Up Scholarship are you on?
    *

  • Are you on School Readiness?
    * Yes   No

  • Do you have specific questions regarding City Church Academy that were not answered on CCA website?
    * Yes   No

  • Please write your questions below:
    *

  • If you would like to take a tour and receive Admissions information for next school year?
    * Yes   No
  •  
  • Student 1
  • First Name *
    Last Name *
  • Birthdate *
    (mm/dd/yyyy)
    Gender *
  • Grade Level of Interest *
    School Year *
  • Current School
  •  
  • Is There Another Student?
    Yes No
  •  
  • Parent / Guardian Notes
  •