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Request Information

Thank you for your interest in Campbell County Christian Academy!

Please fill out the form below, and our Admissions Office will contact you shortly to provide additional information regarding your request.

Please note: Grade 7 will be offered beginning with the 2025-2026 school year.  Grade 8 will be offered beginning with the 2026-2027 school year.

* Indicates a required field.

Parent / Guardian Information
  • First Parent / Guardian
  • First Name *
  • Last Name *
  • Salutation *
  • Email Address *
  • Confirm Email Address *
  • Gender *
  • Cell Phone *
  • Second Parent / Guardian
    (leave blank if not applicable)
  • First Name *
  • Last Name *
  • Salutation *
  • Email Address *
  • Confirm Email Address *
  • Gender *
  • Cell Phone *
Home Address
  • Street Address *
  • City *
  • Country *
  • State
    *
  • Zip
    *
  • How Did You Hear About Us?
    Details:
  •  
  • Student 1
  • First Name *
    Last Name *
  • Birthdate *
    (mm/dd/yyyy)
    Gender *
  • Grade Level of Interest *
    School Year *
  • Student Interests
    Sports and Recreation
    Arts and Sciences

  • Current School
    *
  •  
  • Is There Another Student?
    Yes No
  •  
  • Parent / Guardian Notes
  •