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Request Information

Thank you for your interest in Liberty Christian Academy!  Please complete the form below and our Admissions Office will contact you to answer any questions you may have.  

* Indicates a required field.

Parent / Guardian Information
  • First Parent / Guardian
  • First Name *
  • Last Name *
  • Email Address *
  • Confirm Email Address *
  • Cell Phone *
  • Second Parent / Guardian
    (leave blank if not applicable)
  • First Name *
  • Last Name *
  • Email Address *
  • Confirm Email Address *
  • Cell Phone *
  • How Did You Hear About Us? *
    Details:
  • What are your top priorities for your child's education?

  • Have you toured our campus?

    * Yes   No
  •  
  • Student 1
  • First Name *
    Last Name *
  • Birthdate *
    (mm/dd/yyyy)
    Gender *
  • Grade Level of Interest *
    School Year *
  • Current School
  •  
  • Is There Another Student?
    Yes No
  •  
  • Parent / Guardian Notes
  •