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CCA Application & Registration Form
2022-23 School Year
Please complete ONE FORM PER STUDENT
In addition to this form, please complete the TUITION AGREEMENT and MEDICAL/EMERGENCY INFORMATION FORM
*All students applying for classes at CCA should have an approved Notice of Intent on file with their local school board.
Student Last Name
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Student First Name
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Student Email. This must be different from parent and sibling's email addresses. This email is for the CCA LMS only and will not be used for administrative communication.
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Parent Email
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Are you a new family to CCA for the 2022-23 School Year? New families will be required to attend a Meet and Greet Session over the summer months.
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Yes
No
All application fees are non-refundable.
*All payments are made directly to the Academy, payable to “CCA”.
**If you are in need of financial aid or are interested in monitoring a study hall, please see the “Tuition” page of our website and also submit the necessary form.
Agree?
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Yes
No
Volunteer Requirement: Each family is required to volunteer one time per semester in one of following capacities:
(1) morning set-up
(2) afternoon clean-up
(3) lunch monitoring
If this presents a hardship, please email CCA administration at cca4uinfo@gmail.com
NOT REQUIRED IF YOU ARE REIGSTERED FOR ONLINE CLASSES ONLY.
Agree?
*
Yes
No
The tuition for each study hall is $100 per year. However, students are allowed ONE study hall registration at HALF PRICE ($50/year).
If your child has a break between classes they are scheduled for, you must register and pay for a monitored study hall if they will be remaining on campus. This does include time a student is sitting and waiting for a sibling. Study hall fees can be broken up into ten equal payments on the tuition contract.
Agree?
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Yes
No
I understand that I release Chesterfield Christian Academy, the instructors, and/or the facility owner of any liability and/or compensation for any bodily injury or damage/theft to personal property.
I give CCA permission to use photographs taken of my child/ren throughout the school year to be used in publications related to Chesterfield Christian Academy.
Agree?
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Yes
No
Is there any information about your child's learning abilities you would like to share with his/her teacher(s)?
If yes, CCA will contact you before classes begin to discuss the issue.
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Yes
No
CLASS SELECTIONS
Monday Pd 1
*
Please select
STUDENT WILL NOT BE PRESENT THIS PERIOD
Kindergarten Art
1st-2nd Gr Language Arts
3rd-4th Gr History
5th-6th Gr Science
Math 7/6 (2x week)
Pre-Algebra (2x week)
Algebra 2 (2x week)
Biology (Pd 1 and 2)
HS Writing/Grammar 1 (option 1)
Study Hall MON1
Monday Pd 2
*
Please select
STUDENT WILL NOT BE PRESENT THIS PERIOD
Kindergarten (Pd 2 and 3)
1st-2nd Gr Social Studies
3rd-4th Gr Science
5th-6th Gr Art
MS Writing/Grammar (option 1)
MS Spanish 1A
Biology (Pd 1 and 2)
Chemistry (2x week)
Pre-Calculus (2x week)
HS Writing/Grammar 2
Study Hall MON2
Monday Pd 3
*
Please select
STUDENT WILL NOT BE PRESENT THIS PERIOD
Kindergarten (Pd 2 and 3)
1st-2nd Gr Art
3rd-4th Gr Language Arts
5th-6th Gr History
MS Writing/Grammar (option 2)
Algebra 1 (2x week)
Geometry (2x week)
Advanced Literature (2x week)
Spanish 3 (2x week)
German 3 (2x week)
Study Hall MON3
Monday Pd 4
*
Please select
STUDENT WILL NOT BE PRESENT THIS PERIOD
1st-2nd Gr Science
3rd-4th Gr Art
5th-6th Gr Language Arts (Pd 4 and 5)
MS Literture (option 1)
MS Science
Government/Economics
Spanish 1 (2x week)
German 1 (2x week)
Study Hall MON4
Monday Pd 5
*
Please select
STUDENT WILL NOT BE PRESENT THIS PERIOD
1st-4th Enrichment
5th-6th Gr Language Arts (Pd 4 and 5)
MS Literture (option 2)
MS American History
Physical Science
Spanish 2 (2x week)
German 2 (2x week)
MS/HS Culinary Arts
SAT Prep / Personal Finance
Study Hall MON5
Thursday Pd 1
*
Please select
STUDENT WILL NOT BE PRESENT THIS PERIOD
3rd-6th Gr Sign Language
Math 7/6 (2x week)
Pre-Algebra (2x week)
Algebra 2 (2x week)
Forensics
HS Literature 1
World History (1 yr program)
Study Hall THU1
Thursday Pd 2
*
Please select
STUDENT WILL NOT BE PRESENT THIS PERIOD
3rd-6th Spanish
MS Bible
HS Logic/Programming
HS Geography
World History (2 yr program)
HS Writing/Grammar 1 (option 2)
Pre-Calculus (2x week)
Chemistry(2x week)
Study Hall THU2
Thursday Pd 3
*
Please select
STUDENT WILL NOT BE PRESENT THIS PERIOD
3rd-6th Gr Music
MS Civics/Geography
HS American History
Algebra 1 (2x week)
Geometry (2x week)
Advanced Literature (2x week)
MS/HS Sign Language 3
Spanish 3 (2x week)
German 3 (2x week)
Study Hall THU3
Thursday Pd 4
*
Please select
STUDENT WILL NOT BE PRESENT THIS PERIOD
Kindgerten-2nd Gr Creative Movement (MONTHLY ONLY)
3rd-6th Gr STEM (MONTHLY ONLY)
Physics (Pd 4 and 5)
MS/HS Art (option 1)
Photography
MS/HS Sign Language 2
Spanish 1 (2x week)
German 1 (2x week)
Study Hall THU4
Thursday Pd 5
*
Please select
STUDENT WILL NOT BE PRESENT THIS PERIOD
Kindgerten-2nd Gr STEM (MONTHLY ONLY)
3rd-6th Gr Creative Movement (MONTHLY ONLY)
Physics (Pd 4 and 5)
MS/HS Art (option 2)
MS/HS Sign Language 1
Spanish 2 (2x week)
German 2 (2x week)
Study Hall THU5
Application Fee: There is a one-time application of $55 per student. All application fees are non-refundable with a $150 max per family.
HYBRID and ONLINE CLASSES ONLY: $25 per student
ONCE A MONTH CLASSES Only - $25 Fee per student
I WILL SUBMIT FEE WITHIN SEVEN DAYS OF THIS APPLICATION. I understand that if my fee is not received within one week that my student will not be guaranteed a spot in the requested courses.
Signature
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Clear