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Parent / Guardian Information
First Parent / Guardian First Name * Last Name * Email Address * Confirm Email Address * Cell Phone *

How Did You Hear About Us? * Details: Please contact me to: * Other Is your interest in Preschool 3's or Prekindergarten 4's? * Yes No Please indicate if you would like to register for our Preschool Open House by selecting the date below. Not at this time Is your interest in the grades of Kindergarten through 12th grade? * Yes No Scheduling a tour for a grade in K-12th, what is the preferred day? * Scheduling a tour for a grade in K-12th, what is the preferred time of the day? * Please indicate if you would like to register for our Open House (Preschool to High School) by selecting the date below. Not at this time Does your student have an Individualized Education Program (IEP) or 504 Plan? * Yes No Will you require an F1 Student Visa to attend Contra Costa Christian School? * Yes No Student 1 First Name * Last Name * Gender * Grade Level of Interest * School Year * Is There Another Student? Yes No Please wait Parent / Guardian Notes