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Applicant To Fill This Section

Please complete the section below, then sign the Confidentiality Statement. Give the form to the person you wish to use as a reference. Your reference should not be a member of your immediate family. Please ask your reference to complete the form and return it to Charlotte County Christian Academy.
Confidentiality Statement: Understanding the need for a frank evaluation of Charlotte County Christian Academy’s ability to serve the educational needs of our child, we, the undersigned parents/ guardians of the student(s) named below, hereby waive our right to review this form at a later date in order to allow this document to remain confidential.

Person of Reference To Fill This Section

The family named above has applied for application for their school-aged student(s) to Charlotte County Christian Academy Your frank evaluation will aid CCCA in deciding if we can adequately serve this family in the education of their children. Please complete the following questionnaire and return to Charlotte County Christian Academy PO Box 1092 St. George NB E5C 3S9.

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