Online Form
Current or New Family?
Date  
Thank you for your interest in Champion Preparatory Academy. Our admissions coordinator will contact you to answer any questions you may have, and to provide more in-depth program information.
Family Last Name:
Father/Mother Name:
Address:
Phone:
Email:
Under Program Interest: Please enter the program of interest:
1. Day School-Monday only (1 day)
2. Day School T-W-Th
3. Day School M-Th
4. Day School M-F
5. STAR Program M-F
6. Independent Study Program (T-W-Th)
7. Independent Study Program (M-F)
Scholarship: McKay, Step Up, PLSA or N/A
Student 1: First & Last Name
Student 1: Current Grade Level
Student 1: Program Interest (see above)
Student 1: Wait list-Current year or 2017-2018
Student 2: First & Last Name
Student 2: Current Grade Level
Student 2: Program Interest (see above)
Student 2: Wait List-Current year or 2017-2018
Student 3: First & Last Name/Current Grade
Student 3: Current Grade Level
Student 3: Program Interest (see above)
Student 3: Wait List-Current year or 2017-2018
Comments: