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Request Information/Contact Form

Thank you for your interest in Conestoga Christian School! Please continue filling out this form if you would like more information about CCS, have a tour or shadow day scheduled, or would like to register for an open house. 

Visiting our campus is the best way to learn more about CCS!  Contact the admissions office by calling Michelle Parris at 610-286-0353 x 402 or emailing her at michelle.parris@conestogachristian.net.

Please fill out the form below and our Admissions Office will contact you and provide the information you desire.  

* Indicates a required field.

Parent / Guardian Information
  • First Parent / Guardian
  • First Name *
  • Last Name *
  • Salutation *
  • Email Address *
  • Confirm Email Address *
  • Gender
  • Cell Phone *
  • Second Parent / Guardian
    (leave blank if not applicable)
  • First Name *
  • Last Name *
  • Salutation *
  • Email Address *
  • Confirm Email Address *
  • Gender
  • Cell Phone *
Home Address
  • Street Address
  • City
  • Country
  • State
  • Zip
  • Home Phone
  • How Did You Hear About Us? *
    Details:
  •  
  • Student 1
  • First Name *
    Last Name *
  • Birthdate
    (mm/dd/yyyy)
    Gender
  • Grade Level of Interest *
    School Year *
  • Student Interests
  • Current School
  •  
  • Is There Another Student?
    Yes No
  •  
  • Parent / Guardian Notes
  •