2010-2011 Charter Day School
ONLINE APPLICATION FOR OPEN STUDENT ENROLLMENT
We are currently accepting applications. Please Disable all Pop-Up Blockers.

  
 

Student Information

please do not enter any apostrophes, quotation marks or parenthess into the form fields;
 doing so will produce errors and your application will not be received.

*First Name :
*Email :
*Middle Name :
*Address :
*Last Name :
*City :
*Date Of Birth (mm/dd/yyyy):
*State :
*Age :
*Zip :
*Gender :
*County :
*Race :

Black
American Indian
White
Asian
Hawaiian/Pacific

*Grade Applying For :
If child has sibling currently enrolled, please provide name of student :
*Ethnicity :

Non-Hispanic
Hispanic

 

Family Information

  
 
Father First Name :
Mother First Name :
Father Last Name :
Mother Last Name :
Father's Phone :
Mother's Phone :
Father's Address :
Mother's Address :
Father's City :
Mother's City :
Father's State :
Mother's State :
Father's Zip :
Mother's Zip :
Father's County :
Mother's County :
Father's Occupation :
Mother's Occupation :
 
 
With whom does child reside?

If other please explain below

Mobile Phone :

Academic Background

     
Former School :
    
Former School Address :
   
Former School Phone :
   
Reason For Leaving/OtherNotes:
  

* Required Fields
Double Check Spelling & Accuracy Before Submitting errors in entry may cause errors.
Errors may delay processing and possibly eliminate application from the lottery.