Beekman Charter School 2024-2025 Late Registration Form
Beekman Charter School is a free, public charter school that does not discriminate on the basis of race, creed, national origin, ethnicity, religion, gender, sexual orientation, mental or physical disability, special needs, English language proficiency, athletic ability, or academic achievement. If you falsify any information your application will be voided.
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Student's Legal First Name *
Student's Legal Middle Name *
Student's Legal Last Name *
Student's Birthday *
MM
/
DD
/
YYYY
Sex *
Street Address *
City *
State *
Home Phone Number (please include area code) *
Language spoken at home *
Language most often spoken by student *
Grade placement for NEXT (2024-2025) school year *
Current School *
Current school city *
Current school state *
Female parent/guardian first name *
Female parent/guardian last name *
Relation to student *
Female parent/guardian employer *
Female parent/guardian address *
Female parent/guardian phone number (please include area code) *
Female parent/guardian email address *
Male parent/guardian first name *
Male parent/guardian last name *
Relation to student *
Male parent/guardian employer *
Male parent/guardian address *
Male parent/guardian phone number (please include area code) *
Male parent/guardian email address *
Please list the names and grades of siblings and what school each attends *
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