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Referral Form
Referral Form | High School
Share the gift of a UCA education! Simply complete the referral form below with the information of a family interested in enrolling a high school student/s for the 2025-2026 school year. (One referral form required per new family)
*All referral rewards are applied after the new high school student completes enrollment for the 2025–2026 school year.
Your Information
Please provide your name and contact information as the person referring the new family to UCA. This is how we will track and attribute the $500 tuition discount (or $250 Visa Gift Card) for your referral.
Please select one of the following:
(Required)
I am a UCA "family." (I currently have a child/ren enrolled at UCA.)
I am a UCA "friend." (I do NOT currently have a child/ren enrolled at UCA.)
Your Name
(Required)
First
Last
Your Email
(Required)
Email Address
Confirm Email Address
Your Phone
New Family Information
Please provide the name and contact information (if available) of the new family your are referring to UCA. This is how we will track and attribute the $200 Registration Discount to each eligible new high school student.
Referred Family Name
(Required)
Last
Referred Family Email (if available)
Email Address
Confirm Email Address
Referred Student #1
(Required)
First
Last
Grade of Student #1
(Required)
(entering Fall 2025)
9th Grade
10th Grade
11th Grade
12th Grade
Referred Student #2
First
Last
Grade of Student #2
(entering Fall 2025)
9th Grade
10th Grade
11th Grade
12th Grade
Referred Student #3
First
Last
Grade of Student #3
(entering Fall 2025)
9th Grade
10th Grade
11th Grade
12th Grade
Referred Student #4
First
Last
Grade of Student #4
(entering Fall 2025)
9th Grade
10th Grade
11th Grade
12th Grade
Comments/Questions:
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