Ambassador Christian Academy

Welcome

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Upon submitting this inquiry, the office will contact you within seven days to schedule your tour.

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About the Student

Name

First

Last

Suffix

Preferred Name

Gender

Date of Birth

mm/dd/yyyy

Current Grade

Interested in Grade

for the Fall of

Current School

About the Parent/Guardian

First Parent or Guardian in Primary Household

Name

Title

First

Last

Suffix

Preferred Name

Relationship to Student

Cell Phone (xxx-xxx-xxxx)

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Yes No

Mailing Address

Pastor Name

Pastor Phone Number (xxx-xxx-xxxx)

Yes No

Is there a second parent or legal guardian in this household?

Yes No

Second Parent or Guardian in Primary Household

Name

Title

First

Last

Suffix

Preferred Name

Relationship to Student

Cell Phone (xxx-xxx-xxxx)

Yes No

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