Skip Navigation

Request Information

Thank you for your interest in Regina Caeli Academy!

Please fill out the form below and our Admissions team will contact you to provide more information.  

* Indicates a required field.

Parent / Guardian Information
  • First Parent / Guardian
  • First Name *
  • Last Name *
  • Email Address *
  • Confirm Email Address *
  • Cell Phone *
  • Second Parent / Guardian
    (leave blank if not applicable)
  • First Name *
  • Last Name *
  • Email Address *
  • Confirm Email Address *
  • Cell Phone *
Home Address
  • Street Address *
  • City *
  • Country *
  • State
    *
  • Zip
    *
  • Home Phone
  • How Did You Hear About Us?
    Details:

  • Do you currently homeschool?
    * Yes   No

  • What interests you about Regina Caeli Academy?
    *

  • What center are you inquiring about at this time?
    *

  • Would you like to schedule a tour of one of our active centers?
    Yes   No
  •  
  • Student 1
  • First Name *
    Last Name *
  • Birthdate *
    (mm/dd/yyyy)
  • Grade Level of Interest *
    School Year *
  •  
  • Is There Another Student?
    Yes No
  •  
  • Parent / Guardian Notes
  •