Chestnut Ridge Academy A Homeschool Umbrella

Chestnut Ridge Academy A Homeschool Umbrella

Please fill out the application form carefully
For all new registrations: before filling out this application, please be sure to download and read the Registration Policies found on the website.
Student Information
Student Name *

First Name Last Name
School Year *
Birth Date *

Month Day Year
Student Grade Level *
If student is registering as a 12th grade student, does he/she plan to walk in the spring graduation ceremony? *

Yes, my child plans to walk. No, my child will not walk. Undecided at this time. My child is not a 12th grade student.
Please check one: *

New Student to Chestnut Ridge Academy Renewal
If new to Chestnut Ridge Academy, how did you hear about us? When possible, give a name.
In what public school system does the student currently live? *
For Example: Lincoln County Schools, Fayetteville City Schools, etc.
What is the name of the school the student currently attends? *

Parent Information
Primary Teacher's Name *
This is the person who is taking responsibility for the child's education. This person may hire tutors or sign the child up for classes where he/she is taught by other individuals.
Mother's Name

First Name Last Name
Father's Name

First Name Last Name
E-mail *
Phone Number *

Area Code Phone Number
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Fee Schedule
Fees

9th – 12th Grade:
- $99 1st child
- $85 2nd child
1st-8th Grade:
- $85 1st child
- $75 2nd child
- $65 each additional child registering for 1st-8th grade
Kindergarten:
- $50 per child
Registration Fee Cap per family - $250

Graduating Senior Fee- $100 (Due January 15, 2022 or when the child graduates, whichever comes first. No discounts apply to this fee.)
Chestnut Ridge Academy does not and shall not discriminate on the basis of race, color, religion (creed), gender, age, national origin (ancestry), disability, marital status, or military status, in any of its activities or operations. All admission decisions are made after prayerfully considering the best interest of the applicant and the Chestnut Ridge Academy and Satellite Program as a whole. CRA seeks to foster and preserve a positive, Christian atmosphere for all students. Generally, applicants cannot begin until all academic records have been collected from prior schools and a thorough evaluation of those records is conducted. In some unusual circumstances, however, provisional admission may be granted until all records are received by the CRA Director. If provisional admission is granted, parents agree to abide by the final admission decision.
By signing here, I understand and accept all the above conditions and certify that all information given is true and correct to the best of my knowledge.

Clear

Payment information
Student Fee (Do NOT include graduating senior fee)
Graduation Fee (for high school seniors only)
Total Amount Owed
You may pay the Total Amount Owed by sending a check or money order to: Chestnut Ridge Academy, PO Box 49, Fayetteville, TN 37334. You may also pay cash in person or use your credit or debit card below. Please keep all receipts of payment in a safe place.

Registration Fees by Debit or Credit Card

USD Please enter the amount from the Total Amount Owed box above. If you are not sure how much is owed, please call Chestnut Ridge Academy at (931)227-7391)

Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Date	Postal Code

DateTime
Should be Empty:

Chestnut Ridge Academy A Homeschool Umbrella

Student Information

Parent Information

Background Information

Fee Schedule

Payment information