Apply to ACA | Appalachian Christian Academy

Application to Apply for Enrollment at ACA (K-8)

Please take the steps below to submit your application. We require a consent form as well with the application. You can download both PDFs below.

Download the Application Form and Consent Form
Open forms in Acrobat.
Fill in appropriate information
Save Document
Click Submit Button below and attach both forms.
Submit form and await contact from ACA.

Step 1:

Step 2:

Or Fill the Form out Below

Application for Admission

Pupil's Legal Name*
First Middle Last
Nickname:
Birth Date*
Month
Day
Year
Place of Birth:

City, State
Student Social Security #
Sex:
- Male
- Female
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Home Phone
Cell Phone
Are you a parent?
- Yes
- No
Father Information:
Father's Name
First Last
Check one:
- Natural
- Step
- Foster
Address
Same as above address:

Street Address Address Line 2 City State ZIP Code
Home Phone
Cell Phone
Occupation:
Education:
Business Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Business Phone
Birth Date
Month
Day
Year
Birthplace
U.S. Citizen:
- Yes
- No
- Other
Marital Status
- Married
- Divorced
- Other
Mother Information:
Legal Name
First Last
Check one:
- Natural
- Step
- Foster
Address
Same as above

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Home Phone
Cell Phone
Text?
Occupation:
Education:
Business Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Business Phone
Birth Date
Month
Day
Year
Birthplace:
U.S. Citizen:
- Yes
- No
- Other
Marital Status:
- Married
- Divorced
- Other
Guardian
Are you a guardian?*
- Yes
- No
(non-parent)
Legal Name
First Last
Relation to child:
Address
Same address as above

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Home Phone
Cell Phone
Occupation:
Education:
Business Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Business Phone:
Birth Date
Month
Day
Year
Birthplace
U.S. Citizen
- Yes
- No
- Other
SDA Member
- Yes
- No
- Other
Martial Status
- Married
- Divorce
- Other
Other Information:
Other persons living with family:
Relationship to child
Church child attends:
Denomination:
Baptism place:
Date of Baptism
Month
Day
Year
Age at Baptism
Children in the family in order of birth including this child:
Full Name: Living at Home (Yes or No): Date of Birth (mm/dd/yy)
Factors which may interfere with Child’s learning: (check all that apply)
- Hearing
- Heart
- Worrying
- ADD
- Sight
- Language other than English
- Nervousness
More:
- Dyslexia
- Speech
- Easy Fatigue
- Malnutrition
- Emotional problems
- ADHD
- Other
If you checked "Other" please explain:
Has the student ever been suspended or expelled from any school? If yes, Please explain with dates:
Has the student repeated any grades? If so what grade(s) and what was the reason:
Any additional comments about the student that you would like us to know:
Name: Parent or Guardian*
Signature*
Date*
Month
Day
Year

Financial Aid Application

If you would like to request financial aid consideration, please click to fill out a form and submit.

Appalachian Christian Academy

619 Memorial Dr., Manchester, KY 40962
(Physical Address)

168 SDA School Rd. (Mailing Address)

(606) 598-5427
info@learnACA.org

Our Mission:

The Appalachian Christian Academy family exists to show children Jesus, nurture their love for Him and others, teach them to think, and empower them to serve.

Full Name:	Living at Home (Yes or No):	Date of Birth (mm/dd/yy)

Application to Apply for Enrollment at ACA (K-8)

Step 1:

Step 2:

Or Fill the Form out Below

Application for Admission

Father Information:

Mother Information:

Guardian

Other Information:

Financial Aid Application

Appalachian Christian Academy

Our Mission: