Admissions Inquiry

Thank you for your interest in Eagle's Landing Christian Academy. Please complete the following form to receive information about our application process and upcoming events.

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Student Information

*required field

* First Name
Middle Name
* Last Name
Suffix

* Gender
* Date of Birth		(mm/dd/yyyy)

*Home Address

* City
* State
* Zip Code

* Phone Number

(xxx-xxx-xxxx)

Proposed Entry to Eagle's Landing Christian Academy

* Grade

* Year

Current School

* Grade

* School Name

If you are interested in applying to ELCA for more than one child, please list additional names and the grades for which your children are applying in the box below.

Parent/Guardian #1 Information (for household in which student primarily resides):

* Name

* Relationship

Parent/Guardian #2 Information:

* Name

* Relationship

Specific Information Request

By submitting this request form, you will receive information about our application process and upcoming events via email. Note that the ELCA student application is available online. Please specify any additional information that you would like to receive through the U.S. mail.

Thank you for requesting information about ELCA. If you have any questions about the Admissions process, please feel free to contact our office at (678)-818-1072.

When you are finished, please click "Send Form" to complete this form.