Christian Institute of Arts & Sciences 2007 N. 61st Avenue   * Pensacola , FL 32506   *  Fax 850-458-5132  *  Phone 850-457-4058

Preliminary Enrollment Form

(Print this form to start the enrollment process)

I wish to enroll my child(ren) in the Christian Institute of Arts & Sciences.  Enclosed is a $35 registration fee for each student enrolled.  Please send me the students handbook and all necessary forms for enrollment. (Make checks and money orders payable to CIAS).

Date___________  

Our School Year begins (Month) _____________ and ends (Month) ______________   

Parent(s) Name ______________________________ Home Phone_____________ Cell __________________

Address ____________________________________ City _____________ ST _____ Zip Code ____________

Email Address (if any) _____________________________________

Name of last School Attended _________________________________________________________________

Address of last school attended ____________________________________

City _____________ ST _____ Zip Code ____________

Student's Name ________________________________ M __ F __ Birthdate _____________ Grade ______

Student's Name ________________________________ M __ F __ Birthdate _____________ Grade ______

Student's Name ________________________________ M __ F __ Birthdate _____________ Grade ______

Student's Name ________________________________ M __ F __ Birthdate _____________ Grade ______