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Prospective Family Interest Form

Thank you for your interest in Burlington Christian Academy!

We are grateful for the opportunity to connect with your family and share what becoming a Royal can mean for you.

As a reminder: Students applying for Grades K3–K5 must meet the required age by August 31.

* Indicates a required field.

Parent / Guardian Information
  • First Parent / Guardian
  • First Name *
  • Last Name *
  • Salutation
  • Email Address *
  • Confirm Email Address *
  • Cell Phone *
  • Second Parent / Guardian
    (leave blank if not applicable)
  • First Name *
  • Last Name *
  • Salutation
  • Email Address *
  • Confirm Email Address *
  • Cell Phone *
  • How Did You Hear About Us? *
    Details:

  • Please register for event(s) that may be of interest to your family.
  •  
  • Student 1
  • First Name *
    Middle Name
    Last Name *
  • Birthdate *
    (mm/dd/yyyy)
    Gender *
  • Grade Level of Interest *
    School Year *
  • Current School
  •  
  • Is There Another Student?
    Yes No
  •  
  • Parent / Guardian Notes
  •