New Student Online Enrollment

Online Enrollment Access

New Student Enrollment: Account Request

This form is the first step to enrolling your new student online. Complete it to request an account that you will use to log in to a secure Online Enrollment system.
Welcome, and thank you for your interest in exploring the educational opportunities Crossroads Charter Academy has to offer! *If you wish to enroll a NEW student at CCA, you must provide information for the required fields (those displayed with an ) to request an enrollment account.**

Enter the name of the legal parent/guardian of the student you want to enroll

Guardian Legal First Name:

Guardian Legal Last Name:

Guardian Legal Middle Name:

Guardian Legal Name Prefix:

Guardian Legal Name Suffix:

Guardian contact information

Guardian Email Address:
Re-type Email Address:
Guardian Primary Phone Number:

Complete the security dialog

Asterisk (*) denotes a required field