Ethnicity *

Is the applicant child bilingual/multi-lingual?

Yes

Please Specify the Languages Spoken *

Primary Language Spoken at Home *

Does the student have an IEP or 504 Plan? *

Yes

Current or previous school of record *

Full Address

City, State, and Zip Code *

If student is in high school, are there any credits that will be transferred from a previous school?

Yes

(Not applicable) Student is not in high school

Upload a digital copy/photo of the transcript or report card

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF ( max 50 Files )

Please check this box if the mother is deceased and skip this section

deceased

Mother's Full Name

House Number & Street Name:

City, State, and Postal Code

Phone number

Occupation

Please check this box if the father is deceased and skip this section

deceased

Father's Full Name

Please select this box if the address is the same as above and skip to Emergency Contact section

same as above

Father's Address

City. State, & Postal Code

Father's phone number

Personal Email Address:

Father's Occupation

Student Lives With *

Both Parents

Mother

Father

Appointed Legal Guardian (Neither Parent)

Emergency Contact Full Name: *

Contact Number (in case of emergency) *

List any siblings that will be or are currently enrolled in (CAS)

How did you hear about Christian Academy of Success? *

Additional Information

Acknowledgement, Authorization, and Consent

By signing this enrollment form, I hereby acknowledge and agree to the following: I authorize Christian Academy of Success, a subsidiary of Triumph Association ETC, LLC, to use the information provided in this application for the purpose of processing my child’s enrollment. I understand that the information shared herein will be used solely for school admission and related administrative purposes in compliance with applicable laws and regulations. I declare that all the information provided in this form is accurate, complete, and true to the best of my knowledge. I acknowledge that any falsification, omission, or misrepresentation of information may result in the denial of this application or subsequent disenrollment. I understand that this application, once submitted, does not guarantee admission to the school. Admission decisions are made in accordance with the school's policies. I acknowledge that all fees associated with the enrollment process, including the down payment, are non-refundable after student has accessed the content, unless explicitly stated otherwise by the founder of the academy. I consent to Christian Academy of Success contacting me via the provided contact details for the purpose of communication regarding my child’s enrollment, educational updates, and other relevant school matters. I understand that Christian Academy of Success is a private school where daily prayer is offered at 8:00 am CST and Bible study at 8:30 am CST on Wednesdays. (Times and dates are subject to change, and families will be notified accordingly.) Attendance at these sessions is highly encouraged, as they are an integral part of the school's curriculum designed to enhance the mind, body, soul, spirit, and knowledge of each student. The academy honors God and emphasizes the importance of prayer, worship, and praise within its educational environment, providing a platform for students to grow spiritually while excelling academically. The peace and love fostered by this program are extended to all families involved. I understand that I am receiving a discounted tuition rate by enrolling in the STEAM program, which requires my child to attend a weekly science lecture every Wednesday at 7:00 pm CST. If an extreme situation prevents attendance, my child may watch the recorded session and submit a comment to document their attendance. If we choose not to participate in the STEAM program, I acknowledge that I will be required to pay the non-discounted tuition rate for my child. Tuition rates reflect a reduced fee for military personnel, educators, first responders, and emergency public service workers. Additionally, a sibling discount of 5% will be applied for the second child, with a 10% discount for each additional sibling thereafter. Please be sure to list all siblings on the enrollment form to ensure the discount is processed. The sibling discount will be issued in the form of a rebate and sent within 14 days of enrollment. I understand that Triumph Association ETC, LLC and Christian Academy of Success may retain this information for record-keeping purposes, and that all personal data will be handled in accordance with the school's privacy policies and applicable data protection laws. *

I acknowledge that I have read and understood the Acknowledgement, Authorization, and Consent section, and I agree to the terms outlined herein.

Signature of Parent/Guardian *

Clear

Date of Signature *

Congratulations on joining the CAS family (3rd, 4th, or 5th grader). Please select the best time for an Enrollment Counselor to meet with you to finalize the enrollment process and answer any questions you might have. *

8:00 am - 11:30 am CST

12:00 pm - 4:00 pm CST

5:00 pm - 8:00 pm CST

Saturday 10:00 am - 5:00 pm

Application Form for PreK-12 School

Acknowledgement, Authorization, and Consent