Classical Conversations Tampa

"To know God and to make Him known.”

Please copy the entire form and paste it to the body of an email and submit it to the appropriate Challenge DirectorPlease complete this form in its entirety.  A confirmation email will be sent to you upon receipt of your registration form.  

 

Classical Conversations® Program Participation

Challenge Email Registration

Application for 2014-15

 

Parent(s)/Guardian(s) Name:  

Address:  

City:  

State:  

Zip:  

Home Phone:    

Cell Phone:  

Email Address:  

 

Student 1

Name:  

Age:  

DOB:  

Grade:

Student email (even if same as parents):  

Emergency contact and number:  

Doctor name and number:  

   
Name of Previous CC Campus you have participated in if other than this Tampa Campus:    
  Please give a brief history of students past educational experiences.  
 What do you see as your student’s educational strengths and weaknesses?    
Is your student involved in any extra-curricular activities?