Admission Form

The Village Christian Academy

200 Sims Parkway Harrisburg, North Carolina 28075

(704) 456-7196

dont_contact_me_ever@hotmail.com

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Basic Information:

Student Name:

Admission No:

Birth Date:

Gender:

Blood Group:

Religion:

Contact Information:

Phone:

National ID:

Present Address:

Permanent Address:

Academic Information:

Class:

Section:

Group:

Second Language:

Previous School Information:

Previous School:

Previous Class:

Father Information:

Father Name:

Father Phone:

Father Education:

Father Profession:

Father Designation:

Mother Information:

Mother Name:

Mother Phone:

Mother Education:

Mother Profession:

Mother Designation:

Other Information:

Email:

Health Condition :

Other Info:

Guardian Information:

Guardian Name:

Relation With Guardian :