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Request Information

Thank you for your interest in Impact Christian Academy!

Please fill out the form below, and our Admissions Office will contact you shortly to provide additional information regarding your request. If you have any questions please feel free to email icaadmissions@impactcs.org.

* Indicates a required field.

Parent / Guardian Information
  • First Parent / Guardian
  • First Name *
  • Last Name *
  • Salutation
  • Email Address *
  • Confirm Email Address *
  • Gender
  • Cell Phone
  • Home Phone
  • How Did You Hear About Us?
    Details:

  • I would like additional information about the Wisconsin Parental Choice Program.
    Yes   No

  • Please join us for one of our upcoming open houses on January 30, February 2, February 26, or March 13. Follow the link to sign up:

    https://docs.google.com/forms/d/e/1FAIpQLSceTCsDflk7TE0WeP9vMkd83gSTVydY5HnDKAALEvdKHW8WSA/viewform
  •  
  • Student 1
  • First Name *
    Last Name *
  • Birthdate
    (mm/dd/yyyy)
    Gender
  • Grade Level of Interest *
    School Year *
  • Current School
  •  
  • Is There Another Student?
    Yes No
  •  
  • Parent / Guardian Notes
  •