Editing previous response:

Please fix the highlighted areas below before submitting.

North Central Indiana Academy Interest Form

Please complete the form below. Required fields marked with an asterisk *

NCIA

Welcome to North Central Indiana Academy! We are excited to help you on your path to graduation. Once you complete the form, someone from the Guidance Department will reach out to you with information on next steps.

Student Full Legal Name*

Answer required for "Student Full Legal Name"

Student Date of Birth*

Answer required for "Student Date of Birth"

Current Grade Level*

Answer required for "Current Grade Level"

Name of School Currently Attending*

Answer required for "Name of School Currently Attending"

Custodial Parent/Legal Guardian Name*

Answer required for "Custodial Parent/Legal Guardian Name"

Custodial Parent/Legal Guardian Email*

Answer required for "Custodial Parent/Legal Guardian Email"

Custodial Parent/Legal Guardian Phone Number*

Number Required

Current School Transcript

Answer required for "Current School Transcript"

Choose a file or drag it here.

Confirmation Email

Answer required for "Confirmation Email"