2023-2024 New Student Pre-Enrollment Application
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Charter School Campus Name (Nombre del campus de la escuela charter) *
Please select the District your child is zoned for according to your address. Your address must be within the zone of one of the following Districts in order for your child to be enrolled at Priority Charter Schools. *
Please enter the name of the school within the District your child is zoned for. *
Student Information (Informacion Estudiantil)
Required Information (informacion requerida)*  
Please enter name as shown on birth certificate (Por favor ingrese el nombre como se muestra en el certificado de nacimiento)
Last Name (Apellido)* *
Suffix (Sufijo)
First Name (Primer Nombre)* *
Middle Initial (Inicial del segundo nombre)* *
Gender (Genero)* *
Date of Birth (Fecha de nacimiento)* *
MM
/
DD
/
YYYY
Grade Applying for (Grado que solicita)* *
Voluntary Information (informacion voluntaria)
If yes, please enter the name of the student's sibling, staff, or board member. (En caso si, ingrese el nombre del hermano, el personal o el miembro de la junta)
I have another child attending this charter school (Tengo otro hijo que asiste a esta escuela charter)
Clear selection
If yes child(s) first and last name (Si, Primer y Nombre Apellido)
This is a child of a staff or board member (Este es un hijo de un miembro del personal o de la junta)
Clear selection
If yes, staff or board members first and last name (Si, Primer Nombre y Apellido)
Student Identification Number (if known) or Last four (4) digits of Social Security Number (SSN) (Numero de identificacion del estudiante (si se conoce) o Ultimos cuatro numeros de Numero de Seguro Social)
Primary Guardian Information (Tutor Legal)
Last Name (Apellido)* *
First Name (Primer Nombre)* *
Street Address of Primary Residence (Direccion de la residencia principal)* *
City (Ciudad)* *
State (Estado)* *
Zip Code (Codigo Postal)* *
Contact Phone Number (Telefono de contacto)* *
Email Address (Correo Electronico)
How did you learn about us? *
CERTIFICATION (Required):
CERTIFICACION (Requerida):
This school does not discriminate on the basis of sex, national origin, ethnicity, religion, disability, or academic or athletic ability. (Esta esuela no discrimina por sexo, orgen nacional, etnia, religion, discapacidad, or capacidad academica o atletica.)
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