2017-2018 Open House Registration

We invite you to visit our campus for an open house. Please register for an open house below.
We look forward to meeting you!

Please remember that this is an adult-only event.

Remember, applicants must meet the following criteria to be considered for admission:

1. All students must live with a single adult (mother, grandmother, uncle, aunt, etc) demonstrating economic need;

2. All students must be 3 years old by September 2018;

3. All students must live within a 15 mile radius from the school.

1. Parent/Guardian's Name *This question is required.

Parent/Guardian's First Name

Parent/Guardian's Last Name

2. Parent/Guardian's Email Address *This question is required. This question requires a valid email address.

3. Parent/Guardian's Phone Number *This question is required. This question requires a valid number format.

4. What is your legal marital status? *This question is required.

5. How did you find out about CSA? *This question is required.

Family / Friend
Internet Search
CSA Student Family
Organization
Other Please enter an 'other' value for this selection. * This question is required.

What is the organization?

About the Applicant

7. Child's Name *This question is required.

Child's First Name

Child's Last Name

8. Date of Birth *This question is required. This question requires a valid date format of MM/DD/YYYY.

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