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Out of School Time Enrichment Academy

Apply now to enroll your child in our after school program. Registration is now open for all SSCLC students!

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Apply For Our After School Program Now!

We welcome your interest in enrolling your child(ren) in the St. Stephens Christian Academy Out Of School Time Programming. Admission is based on the completion of the application process and requirements.

Student Information

Application Date *
School Year *
Proposed Entry Date *
Grade *
School Attending *
Student First Name *
Student Last Name *
Sex *
Street Address *
City *
State *
Zip Code *
Home Phone (recomended)
Date of Birth *
Student Email *
Current Care *

Parent 1

I am the students: *
First Name *
Last Name *
Email *
Cell Phone (recommended)
Street Address *
Employer
Occupation/Title
Business Phone

Parent 2

I am the students: *
First Name
Last Name
Email
Cell Phone (recommended)
Street Address
Employer
Occupation/Title
Business Phone
Parental Marital Status *
If parents are divorced, whom does the student live with?
Correspondence regarding application should be sent to:
Name *
Street Address *
City *
State *
Zip Code *
Has the student been tested for or diagnosed with: *
If yes, explain:
Does your student have any physical disabilities? *
If yes, explain:
Are there any unusual factors in the student's life (absent parent, serious illnesses, accidents, etc.)? If yes, explain:
Signature of Parent/Guardian *
Sign Here
Date *
Printed Name Of Parent/Guardian *
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