MOSAICS Public School Wait List Application for 2020-21
By completing this application, you are entering your child onto the wait list for the 2020-21 school year.  Completing this application does not guarantee your child a spot at MOSAICS Public School.  There are 60 seats per grade level in grades K-4 available.  Applications submitted after March 7, 2020 will be placed on the wait list in the order received. If spaces are available, families will be contacted and will be able to enroll their child for the 2020-21 school year.  

When filling out your application, please note that kindergartners must be age 5 on or before Sept 1, 2020 and first graders must be 6 on or before Sept 1, 2020. Proof of family relationship may be required for verification. Upon acceptance into MOSAICS Public School, a birth certificate, proof of residence, 504, IEP, and immunization records may be requested for verification.

For more information about the lottery process, please visit www.mosaicsps.org 

All prospective students will be given the opportunity to enroll regardless of race, color, national or ethnic origin, religion, gender or social or economic status or special needs.



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Email *
Parent/Legal Guardian First and Last Name *
Additional Parent/Legal Guardian First and Last Name
Home Address (Street, City, Zip Code) *
Mailing Address --if different than home  (Street, City, Zip Code) *
Phone Number (with Area Code) *
Additional Phone Number  (with Area Code)
Additional E-mail Addresses (Please enter all the email addresses that you check frequently.  Separate emails by comma.)
What is your child's first name? *
What is your child's last name? *
What is your child's date of birth? Please note that kindergartners must be age 5 on or before Sept 1, 2020 and first graders must be 6 on or before Sept 1, 2020. *
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Which grade will he or she be enrolling into in 2020-21? *
Name of  last school attended *
Before submitting this application, the parent or legal guardian of the children understand the following: I understand that any false or incorrect information on this application could jeopardize my child's enrollment should he/she be selected to attend MOSAICS Public School. I am authorized to sign as parent/legal guardian of the child(ren) on this application and the child(ren) on this application resides with me at least 50% of the time. Please sign electronically below. *
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