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Thank you for your interest in Emmanuel Christian Academy!

Please complete the inquiry form below and a member of our admissions team will contact you.

* Indicates a required field.

Parent / Guardian Information
  • First Parent / Guardian
  • First Name *
  • Middle Name
  • Last Name *
  • Salutation *
  • Email Address *
  • Confirm Email Address *
  • Gender *
Home Address
  • Street Address *
  • City *
  • Country *
  • State
    *
  • Zip
    *
  • Home Phone *
  • How did you hear about us? *
    Details:
  •  
  • Student 1
  • First Name *
    Middle Name
    Last Name *
  • Birthdate *
    (mm/dd/yyyy)
    Gender *
  • Grade Level of Interest *
    School Year *
  • Current School
    Other:

  • What is your child's public district building assignment?
    *

  • Does your child have a current ETR or IEP? If so, are you currently using any state scholarships? If yes, please specify what scholarship your child is using.
    *
  •  
  • Is There Another Student?
    Yes No
  •  
  • Parent / Guardian Notes
  •