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Thank you for your interest in Heritage Christian School. Feel free to reach out with any questions along the way. 

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Parent / Guardian Information
  • First Parent / Guardian
  • First Name *
  • Last Name *
  • Email Address *
  • Confirm Email Address *
  • Gender
  • Work Phone
  • Cell Phone *
  • Second Parent / Guardian
    (leave blank if not applicable)
  • First Name *
  • Last Name *
  • Email Address *
  • Confirm Email Address *
  • Gender
  • Work Phone
  • Cell Phone *
Home Address
  • Street Address *
  • City *
  • Country *
  • State
    *
  • Zip
    *
  • Home Phone

  • Occupation:
    *

  • Employer:
    *

  • Marital Status
    *

  • How did you hear about us? 
    *

  • Enrollment Responsible Parent
    *

  • Financially Responsible Parent
    *

  • Do you plan to enroll in the Hope Scholarship? 
    Yes   No
  •  
  • Student 1
  • First Name *
    Middle Name
    Last Name *
  • Birthdate *
    (mm/dd/yyyy)
    Gender
  • Email Address
    Confirm Email Address
  • Grade Level of Interest *
    School Year *
  • Student Interests
  • Current School
    Other:

  • Age:
    *

  • Child by:
    *

  • Please Check all mental, emotion, physical impairments for children (Response will be held confidential.)
    *

  • Has the child been tested for any special needs?
    * Yes   No

  • If yes, explain:
    *

  • Has child experienced such disciplinary actions as detentions, suspension, expulsion, probation, or police records? 
    * Yes   No

  • If yes, explain:
    *

  • Church or denominational affiliation:
    *

  • Name of Church
    *
  •  
  • Is There Another Student?
    Yes No
  •