Name of Father

First Name

Last Name

Phone of Father

(###)

###

####

Name of Mother

First Name

Last Name

Phone of Mother

(###)

###

####

Family Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Please select your top three reasons for why you would send your child(ren) to Chesterton Academy: *

Classical Education

Formation in Virtue

Daily Mass

Teachers Who Take the Oath of Fidelity to the Magisterium

Fine Arts

Catholic Identity/Culture

Affordable Tuition

Location

Joyful Environment

High Academic Standards

School Location *

Which region of Fort Wayne is your preferred school location?

North Fort Wayne

Southwest Fort Wayne

Downtown Fort Wayne

West Fort Wayne (University of Saint Francis Area)

In which of the following locations do you prefer the school NOT be located?

North Fort Wayne

Southwest Fort Wayne

Downtown Fort Wayne

West Fort Wayne (University of Saint Francis Area)

Student 1 *

First Name

Last Name

Birthdate (Student 1)

MM

DD

YYYY

Student 2

First Name

Last Name

Birthdate (Student 2)

MM

DD

YYYY

Student 3

First Name

Last Name

Birthdate

MM

DD

YYYY