2025-2026 REGISTRATION | Salem Christian Academy

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WELCOME TO 2025-2026 STUDENT REGISTRATION APPLICATION

"*" indicates required fields

Today's date*

MM slash DD slash YYYY

Student's Full Name*

First Last

Gender*

Male

Female

Address*

Street Address Address Line 2 City State ZIP Code

Completed grade at the end of 2024-2025 year:*

Grade to be registered for 2025-2026 year:*

Date of birth*

MM slash DD slash YYYY

Student's age on September 10th 2025:*

Please enter a number from 4 to 18.

Mother's Full Name*

First Last

Cell phone number*

Email*

Father's Full Name

First Last

Cell phone number

Email

Other than parents emergency contact 1*

Relationship*

Phone number*

Other than parents emergency contact 2

Relationship

Phone number

What is the student's primary language?*

Does the student speak English?*

Yes

No

Is the student being transferred from another school?*

Yes

No

Name of the school the student is transferring from*

Finished grade*

School address*

School fax number*

Does the student have any medical issues or allergies?*

Yes

No

Please, explain in detail:*

Do you have any outstanding balance (tuition and/or lunches) for this student for the past 24-25 year?*

No

Yes

I don't know

Please, briefly describe how and when you are going to pay it off.*

PLEASE, CONTACT THE OFFICE TO FIND OUT THE STATUS OF YOUR FINANCIAL STANDING BEFORE THE BEGINNING OF A NEW SCHOOL YEAR.

Please, indicate below how do you plan to cover all the FEES and TUITION expenses.*

Working at school

Working and paying the remainder

Using my accumulated school credit

10 months payment plan (no discount)

9 months payment plan (no discount)

2 times payment (in Sep, in Jan) (2% discount)

1 time payment (in Sep.) (5% discount)

Consent*

Me and my student agree to comply with the Dress Code Policy.*

Consent*

Me and my student agree to comply with the Demerit and Detention Policy.*

To complete the registration process, it is necessary to make a deposit payment for the books. Please, mark your selection from the options below and proceed to the payment.

I'm paying the deposit of $100 per bookset per student with:*

Check, card or cash

My school credits