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Thank you for your interest in Little Rock Christian Academy

We would love to learn more about you! 

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Parent / Guardian Information
  • First Parent / Guardian
  • First Name *
  • Last Name *
  • Email Address *
  • Confirm Email Address *
  • Cell Phone *
  • Second Parent / Guardian
    (leave blank if not applicable)
  • First Name *
  • Last Name *
  • Email Address *
  • Confirm Email Address *
  • Cell Phone *

  • Do you currently attend church?
    * Yes   No

  • If so, which church do you consider your church home?
    *
  •  
  • Student 1
  • First Name *
    Last Name *
  • Birthdate
    (mm/dd/yyyy)
    Gender *
  • Grade Level of Interest *
    School Year *

  • School currently attending?
    *
  •  
  • Is There Another Student?
    Yes No
  •  
  • Parent / Guardian Notes
  •