Preliminary Enrollment Form

(Print this form to start the enrollment process)

I wish to enroll my child(ren) in the Christian Institute of Arts & Sciences.  Enclosed is a $25 registration fee for each student enrolled.  Please send me the students handbook and all necessary forms for enrollment. (Make checks and money orders payable to CIAS).

Date___________   Our School Year begins (Month)_____________and ends (Month)______________   

Parent(s) Name______________________________Phone_____________Fax__________________

Address__________________________________City_____________ST____Zip Code__________

Email Address (if any)_________________Name of last School Attended________________________

Address of last school attended____________________________City__________ST____Zip Code______

Student's Name________________________________M__F__Birthdate_____________Grade______

Student's Name________________________________M__F__Birthdate_____________Grade______

Student's Name________________________________M__F__Birthdate_____________Grade______

Student's Name________________________________M__F__Birthdate_____________Grade______

Student's Name________________________________M__F__Birthdate_____________Grade______