Charter School Admission Form

Charter School Admission Form

Please complete this form to assess and understand the needs, interests, and preferences of students and families.

Student Information

Name

    Date of Birth

      Gender

        • Male

        • Female

        Grade Level Applying For

        Previous School Attended

        Parent/Guardian Information

        Parent/Guardian Name

        Relationship to Student

        Phone number

          Email

            Occupation

            Emergency Contact Information

            Emergency Contact Name

            Relationship to Student

            Phone number

              Academic and Health Information

              Does the student have any learning or developmental needs?

              Does the student have any medical condition?

              Are you interested in after-school programs?

              Agreement

              I affirm that all information provided in this application is accurate to the best of my knowledge. I understand that any false information may affect the student’s admission status.

              Parent/Guardian

              Name:

              Date:

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              Thank You for Your Submission!

              Our admissions team will carefully review your application, and we will contact you shortly regarding the next steps.

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