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Request Information

Thank you for your interest in Pine Harbor Christian Academy!

Please fill out the form below and our Admissions Office will reach out soon.

* Indicates a required field.

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

  • Would you like us to email you an information packet, including our tuition schedule and other information about our school? If so, please select yes below.

    *Please note that by selecting "yes" below, you are consenting to receive marketing emails from: Harbor Church Ministries, 11125 W Point Douglas Rd, PO Box 54, Hastings, MN, 55033 United States, http://www.pineharbor.org. You can revoke your consent to receive emails at any time by using the SafeUnsubscribe® link, found at the bottom of every email. Emails are serviced by Constant Contact.
    * Yes   No
  •  
  • Student 1
  • First Name *
    Middle 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
  •