Memphis School of Excellence Mendenhall & Winchester Online Student Application Form 2020-2021

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Memphis School of Excellence (MSE) (K-12) is now accepting student applications for the 2020-2021 school year. MSE is a tuition-free, STEM-focused, public charter school, serving Memphis, TN area.

Mendenhall campus: Grades K-8
4450 S Mendenhall Rd. St 1, Memphis, TN 38141

Winchester Campus: Grades 9-12
4921 Winchester Rd. Memphis, TN 38118

Email *

Student Information: (Información del Estudiante)

Student First Name (Nombre del Estudiante*) *

Student Middle Name (Segundo nombre del Estudiante )

Student Last Name (Apellido del Estudiante) *

Date of Birth (Fecha de Nacimiento) *

YYYY

Ethnicity/Race (select all the apply) [Etnicidad/Raza (seleccione todo los que apliquen] *

Ethnicity: Hispanic / Latino (Hispano/Latino)

Race: White (Blanco)

Race: African American (Afro-americano)

Race: Asian (Asiático)

Race: Native American (Nativo-americano)

Race: Pacific Islander / Hawaiian (Islas Pacificas/Hawái)

Required

Address (Dirección) *

Zip Code (Código Postal) *

Home Phone # (Número telefónico Residencial) *

Other Phone # (Otro número telefónico)

Grade Applied For (¿Para qué Grado Escolar Aplica? ) *

Current School (¿A qué escuela atiende actualmente?)

Does the student have any documented history of a criminal offense or juvenile court adjudication? (¿El estudiante tiene historia criminal documentada o adjudicación en la corte juvenil?) *

Yes (Si)

No (No)

Do you have any other child(ren) attending/applied to MSE? *

Yes

Name and Grade level of the siblings?

Parent/Guardian Information: (Información del Padre/Tutor legal)

First Name (Nombre) *

Last Name (Apellido) *

We/I, the undersigned, hereby certify that, to the best of our/my knowledge and belief, the answers to the foregoing questions and statements made by us/me in this application are complete and accurate. We/I understand that any false information, omissions, or misrepresentations of facts may result in rejection of this application or future dismissal of the applicant.

Yo, el/la abajo firmante, afirmo que las respuestas a dichas preguntas y declaraciones hechas por mí en esta aplicación son completas y certeras según mi leal saber y entender. Entiendo que cualquier omisión, distorsión de hechos o falsa información puede resultar en la denegación de esta aplicación o en una futura expulsión del estudiante

NON-DISCRIMINATION STATEMENT: (DECLARACION DE NO-DISCRIMINACION)

It is the policy of Memphis School of Excellence to comply with all state and federal regulations regarding admission and not to discriminate during the admission and the lottery process on the basis of gender, national origin, ethnicity, religion, disability, academic, artistic, athletic ability, or the district the child would otherwise attend.
(Es la póliza de Memphis School of Excellence cumplir con todas las regulaciones federales y del estado en cuanto a las admisiones y de no discriminar durante el proceso de matrícula y lotería en base a género, origen nacional, etnicidad, religión, impedimento, habilidad académica, atlética, o artística, o del distrito designado que de lo contrario atendería el estudiante)

A copy of your responses will be emailed to the address you provided.

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