Welcome to Cesar Chavez Academy-Central, A Premier Public Charter School Serving the Diverse Needs of the Colorado Springs Community

Please note fields marked with an asterisk (*) are required.

* Student's First Name Enrolling student's first name
* Student's Last Name Enrolling student's last name
* Gender Enrolling student's gender
Date of Birth (e.g. 01/19/2003) Enrolling student's date of birth in mm/dd/yyyy format
School Year Year you wish to enroll for
Grade Interested In Enrolling student's projected grade for the school year you selected
Current School Enrolling student's current school
Home School District e.g. D11, D20, D2
Is the sibling of the applicant currently attending this school
If yes, please provide student's name
1st Sibling First Name
1st Sibling Last Name
1st Sibling Gender
1st Sibling Date of Birth
1st Sibling School Year
1st Sibling Grade Interested In
1st Sibling Current School
2nd Sibling First Name
2nd Sibling Last Name
2nd Sibling Gender
2nd Sibling Date of Birth
2nd Sibling School Year
2nd Sibling Grade Interested In
2nd Sibling Current School
Salutation
Mother's First Name
Mother's Last Name
Father's First Name
Father's Last Name
* Mailing Address Street address; include any apartment numbers
* City
* State
* Zip
* Home Phone
Work Phone Enter extension, if required
Mobile Phone
* Email Address
* Preferred Contact Method EmailPhonePostal Mail
* How did you learn about Cesar Chavez Academy - Central ? If Word-of-Mouth, who?
If you would like additional information or have other questions, please enter here

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After you click the SUBMIT button, please call CCA-Central to confirm
your enrollment form was received at 719.227.7152

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