1. family and parenting
2. children

CAYO CHRISTIAN ACADEMY
Cayo Christian Academy | Application Form 2015-2016
Kindly PRINT all responses and ensure you have included all required documents. The office will not
process this Application for Admission unless ALL required documents listed below are submitted.
Attach 1
current
passport
size
picture
here
ϽϽ 1. $15.00 Application Fee.
ϽϽ 2. Attach 1 current
size picture
on the upper
left hand
corner Central
of this form.America
P.O.passport
Box 636,
Belmopan
City,
Belize,
ϽϽ 3. Attach 2 completed Recommendation Forms by Principal and one other person.
+ 501 802 2009 • [email protected]
ϽϽ 4. Attach 1 copy of Social Security Card, Passport, and Valid Birth Certificate.
ϽϽ 5. Attach 1 copy of Standard 5 and 1 copy of Standard 6 Report Cards from previous school.
ϽϽ 6. Attach 1 copy of PSE Result Card.
ϽϽ 7. Submit 1 completed Application Form with supporting documents by JUNE 26, 2015.
A
C
C
SECTION A – APPLICANT’S INFORMATION (1 - 13)
1. Name of Applicant: _______________________________________________________________________
(As appears on birth paper)FirstMiddleLast
2. Sex: Male  Female 
3. Social Security Number:_____________________________________
4. Address: _________________________________
5. Email Address: _____________________________
6. Parents’ Current Phone Number: _____________________________/_____________________________ MotherFather
7. Date of Birth: ____/____/____
DD MM YY
8. Age _______
9. Place of Birth: _____________________________
10. Nationality: ________________________ (Birth Certificate, Social Security or Residency Permit must be presented)
11. In case of an emergency please provide 2 contact persons below:
Name of Contact ________________________________ / ____________________________________
Relationship ________________________________ / ____________________________________
Contact Number ________________________________ / ____________________________________
12. What church do you regularly attend? ______________________________________________________
13. List languages spoken: ___________________________________________________________________
SECTION B – PARENTS/GUARDIANS INFORMATION (14 - 28)
14. Name of Primary Caretaker (who you live with?): ________________________________________________
15. Father’s Name: ________________________________
16. Living  Deceased 
17. Address: _____________________________________
18. Nationality: __________________________
19. Occupation: ____________________ 20. Employer: _________________ 21. Monthly Income: _______
22. Mother’s Name: _______________________________
23. Living  Deceased 
24. Address: ______________________________________ 25. Nationality: __________________________
26. Occupation: ____________________ 27. Employer: _________________ 28. Monthly Income: _______
FOR OFFICIAL USE ONLY - PLEASE DO NOT WRITE IN THIS SECTION
Application Fee Paid Male  Female  Admission Status
Preparatory 
Receipt # _________________________________
First Form 
Not Admitted 
Remarks ____________________________
Principal’s Signature_____________________________
___________________________________
Prep / First Form
Changing the nation through Christian Education
www.ccabelize.com
CAYO CHRISTIAN ACADEMY
SECTION C – FINANCIAL INFORMATION (29 - 32)
29. Will you have a sponsor to help you with your school fees? Yes  No 
30. If yes, who will be sponsoring you? _________________________________________________________
31. If you do not have a sponsor, who will be financially responsible for your school fees? _______________
P.O. Box 636, Belmopan City, Belize, Central America
_________________________________________________________________________________________
+ 501 802 2009
32. Have you applied for Government Subsidy?
Yes  No 
•
[email protected]
SECTION D – EDUCATION (33 - 42)
A
C
C
33. Are you currently enrolled in school?
Yes  No 
34. If yes, provide name, address and phone number of present school:
___________________________________/_________________________________/____________________
Name of School School’s Address
School’s Phone Number
35. Principal’s Name: _______________________________________________________________________
36. If no, name of last school attended and Year: ___________________________________/_____________
Name of School 37. Have you taken the PSE (Please provide official copy of scores)? Yes  No  38. Scores for each subject: English: _____
Math: _____
39. Have you ever repeated a Standard/Grade?
Science: _____
Year
PSE Overall Score: _____
Social Studies: ______
Yes  No 
40. If yes, how many times and what Standard/Grade? ________________/___________________________
Number of Times
Standard/Grade
41. List the names of all schools you have attended (Starting from Pre-school):
____________________________________________________________________________
____________________________________________________________________________
42. Have you applied for admission to any other High School?
Yes  No 
SECTION E – LETTERS OF RECOMMENDATION
Attach a letter of recommendation from previous principal. CCA’s Recommendation Forms are available at
our campus or can be downloaded from our website at www.cayochristianacademy.com/downloads.
SECTION F – DECLARATION
Cayo Christian Academy is an evangelical, non-denominational, Christian high school. As such, it will foster
and encourage a personal relationship with Jesus Christ and promote the Holy Bible as the holy and inerrant
Word of God and the ultimate authority in matters of faith, morals and holy living. Students will receive training in academics, vocations and daily living skills. All students will be required to participate in some or all
school related activities. I certify that all information on this Application Form is correct and fully understand
that any misrepresentation will disqualify this application.
_______________________________
Name of Parent/Guardian
________________________________
Signature of Parent/Guardian
_____/_____/_____
DD MM YY
*Please note that submission of this application does not constitute automatic acceptance into Cayo Christian Academy.
*All information and recommendations must be present and completed for consideration.
This application Form will become part of your permanent record at Cayo Christian Academy. It should be
completed and returned with all necessary documents to: Cayo Christian Academy, Ontario Village, George
Price Highway, Cayo District. For more information call 802.2009 or email [email protected].
Prep / First Form
Changing the nation through Christian Education
www.ccabelize.com
CAYO CHRISTIAN ACADEMY
Cayo Christian Academy | Transfer Application Form 2015-2016
Kindly PRINT all responses and ensure you have included all required documents. The office will not
process this Application for Admission unless ALL required documents listed below are submitted.
Attach 1
current
passport
size
picture
here
ϽϽ 1. $15.00 Application Fee.
ϽϽ 2. Attach 1 current passport size picture on the upper left hand corner of this form.
ϽϽ 3. Attach 1 completed
Recommendation
Form by Principal
previous Central
high school.America
P.O. Box
636, Belmopan
City, ofBelize,
ϽϽ 4. Attach 1 copy of Social Security Card, Passport, and Valid Birth Certificate.
+ 501 802 2009 • [email protected]
ϽϽ 5. Attach 1 copy of Report Cards from previous high school.
ϽϽ 6. Attach 1 copy of official high school transcript.
ϽϽ 7. Please write a letter stating the reason(s) you want to transfer to Cayo Christian Academy.
ϽϽ 8. Submit 1 completed Application Form with supporting documents by JUNE 26, 2015.
A
C
C
SECTION A – APPLICANT’S INFORMATION (1 - 13)
1. Name of Applicant: _______________________________________________________________________
(As appears on birth paper)FirstMiddleLast
2. Sex: Male  Female 
3. Social Security Number:_____________________________________
4. Address: _________________________________
5. Email Address: _____________________________
6. Parents’ Current Phone Number: _____________________________/_____________________________ MotherFather
7. Date of Birth: ____/____/____
DD MM YY
8. Age _______
9. Place of Birth: _____________________________
10. Nationality: ________________________ (Birth Certificate, Social Security or Residency Permit must be presented)
11. In case of an emergency please provide 2 contact persons below:
Name of Contact ________________________________ / ____________________________________
Relationship ________________________________ / ____________________________________
Contact Number ________________________________ / ____________________________________
12. What church do you regularly attend? ______________________________________________________
13. List languages spoken: ___________________________________________________________________
SECTION B – PARENTS/GUARDIANS INFORMATION (14 - 28)
14. Name of Primary Caretaker (who you live with?): ________________________________________________
15. Father’s Name: ________________________________
16. Living  Deceased 
17. Address: _____________________________________
18. Nationality: __________________________
19. Occupation: ____________________ 20. Employer: _________________ 21. Monthly Income: _______
22. Mother’s Name: _______________________________
23. Living  Deceased 
24. Address: ______________________________________ 25. Nationality: __________________________
26. Occupation: ____________________ 27. Employer: _________________ 28. Monthly Income: _______
FOR OFFICIAL USE ONLY - PLEASE DO NOT WRITE IN THIS SECTION
Application Fee Paid Male  Female  Admission Status
First  Second 
Receipt # _________________________________
Third  Fourth Not Admitted 
Remarks ____________________________
Principal’s Signature_____________________________
___________________________________
Prep / First Form
Changing the nation through Christian Education
www.ccabelize.com