Request Information

Thank you for your interest in Cedar Grove Christian Academy. Please provide the following information and someone from our Admissions Office will be in touch with you soon.

Parent / Guardian Information
First Parent / Guardian
Name*
Prefix First Last
- Email*
- Gender*
- Work Phone
- Cell Phone
Second Parent / Guardian
Name*
Prefix First Last
- Email*
- Gender*
- Work Phone
- Cell Phone
Home Address
Address
Street Address Address Line 2 City State ZIP
Home Phone
How Did You Hear About Us?
Student 1
Name
First Middle Last
- Birthdate
  MM slash DD slash YYYY
- Email
- Gender*
- Grade Level of Interest*
- School Year
Current School
Does your student have an IEP/504?*
- Yes
- No
Is There Another Student?
- Yes
- No
Parent / Guardian Notes
CAPTCHA

Parent / Guardian Information

First Parent / Guardian

Second Parent / Guardian

Home Address

Student 1