2022-2023  Request for Enrollment
Placer Academy is a TK-6th grade campus.
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電子郵件 *
Student Legal Name: (Last, First, Middle) *
Gender: *
Parent/Guardian Name(s): *
Student Date of Birth: *
MM
/
DD
/
YYYY
Grade (2022-2023): TK-6th ONLY *
Physical Address: *
Mailing Address: (if different)
Home/Cell Phone: *
Siblings currently (attending or applying at PAC?) *
Name and Grade of siblings either attending or applying.
In the student's home, is there a computer? *
Is there anything else you would like us to know about your child?
How did you hear about PAC? *
I attest that the above statements are true to the best of my knowledge. I understand that falsification of any of the information on this enrollment application may result in the student being disenrolled from the school. *
必填
Parent Signature *
Please Note: PAC complies with all applicable state and federal laws in serving students with disabilities including but not limited to Section 504 of the Americans with disabilities Act and the Individuals with Disabilities in Education Act. The Charter School intends to function as a “public school of the local education agency (LEA) that granted the charter” for purposes of providing special education and related services pursuant to Education Code Section 47641 (b).
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