Design39Campus 2022-2023 Interest Form
This interest form will serve as the initial verification of your interest in enrolling your child at Design39Campus for the 2022-2023 school year. The information you submit on this form will guide the interest process for your child.

The interest process also includes at least one parent/guardian attending an information session at D39C or virtually. Priority will be given to families who attend site information sessions.

Please submit one form per child you would like to participate in the draw at D39C.

We ask that you complete the form as accurately as possible to avoid a delay in your application.
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Email *
Please add the date you attended a tour. Priority will be given to families who attend tours . *
Required
Student's Last Name: *
Student's First Name: *
Student's Date of Birth (mm/dd/yyyy): *
Please choose the Grade Level your child will be in for the 2022/2023 year. *
Required
Student identifies as: *
Student's Street Number for Home Address: (ie 11577) *
Student's Street Name for Home Address: (Please do not use special characters or punctuation and do not include street suffix (ie ST). *
Student's Zip Code for Home Address: *
Name of Primary Contact (Parent/Guardian): *
Primary Contact Phone Number *
Student's Current School of Enrollment: *
Poway Unified Student ID#: (Please skip if student has never been enrolled in PUSD.  If ID# is unknown please write "unknown".) *
Does your student receive special education on a current Individualized Educational Program? (Students with IEPs are included in the draw): *
Please select any special programs your child participates in. A resource specialist may contact you with questions they may have regarding your child's services. *
Required
If you will be submitting an interest form(s) for a sibling of this child, please list the sibling(s) names and 2022-2023 grade level below (an interest from must be submitted for each child):
Siblings currently enrolled at D39C (Please list name of student and PUSD ID number of one sibling attending D39C in 2022-2023.)
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