- Enrollment Application

Enrollment Application

Parent/Guardian Information

Please fill out the form below to enter your students in the upcoming lottery.

Parent First Name:	*
Parent Last Name:	*
Spouse (if applicable):
Street Address:	*
City:	*
State:	*
Zip Code:	*
Home Phone:	*
Other Phone:
Email Address:	*
Re-enter Email Address:
Accept Terms & Conditions:	*	(A check mark indicates agreement)

Student Information

#	First Name*	Last Name*	Gender*	Birth Date*	School year*	Grade* ?
1.

* Indicates a required field.