Section 1: Student Information *

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Gender *

Male

Female

Grade Applying For *

PPK (Age 3)

Pre-K

Kindergarten

1st

2nd

3rd

4th

5th

6th

7th

Has the student previously attended a Christian school? *

Yes

No

If enrolling in PPK Age 3, will the student be potty trained by the start of the school year?

Yes

No

Section 2: Parent/Guardian 1 Information *

First Name

Last Name

Phone *

(###)

###

####

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Section 2: Parent/Guardian 2 Information (Optional)

First Name

Last Name

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Section 3: Academic & Developmental Information

Are there any academic, behavioral, or medical considerations we should be aware of? *

Yes

No

Does your child have any allergies, health conditions, or medications?

Yes

No

Section 4: Faith & Family Life

Is your family actively involved in a church? *

Yes

No

Section 5: Enrollment Preferences & Permissions

How Did You Hear About Us? *

Church

Friend/Family

Social Media

Online Search

Event

Other

Preferred start date *

MM

DD

YYYY

Will you require extended care services? *

Yes

No

Possibly

May the school use your child’s photo (without name) for internal or promotional purposes (e.g., newsletters, website)? *

Yes

No

Signature & Agreement

By signing below, I affirm that the information provided is accurate to the best of my knowledge. I understand that submitting this application does not guarantee admission. I also understand that Grand Lake Christian Academy partners with families in both academic and spiritual formation, and I am committed to engaging in that partnership.