PHILADELPHIA CHARTER SCHOOL COMMON APPLICATION

Current Address *

Date of Birth *

Month Day Year
Date
Gender (optional)
Parent /Guardian *

First Name Last Name
Relationship *
Do you have the legal right to enroll this child in school? *

Yes No
Preferred Contact Number: *

Area Code Phone Number
Secondary Contact Number:

Area Code Phone Number
Email *
example@example.com
Current Grade Level : *
SECTION B: SCHOOL CHOICE INFORMATION
Name of Charter School You Wish To Attend: *
Grade Applying To: *
SECTION C: SIBLING INFORMATION
SIBLING #1

First Name Last Name
Date of Birth

Month Day Year
Date
School Sibling Currently Attends:
SIBLING #2

First Name Last Name
Date of Birth

Month Day Year
Date
School Sibling Currently Attends:
SIBLING #3

First Name Last Name
Date of Birth

Month Day Year
Date
School Sibling Currently Attends:
SECTION D: PARENT/GUARDIAN SIGNATURE

IMPORTANT: By signing this form, you indicate that all information provided is accurate. If any of the information that you have provided changes after turning in this form, please submit an amended form prior to the school’s deadline. Check with the charter school you wish to apply to for application deadlines. YOU MUST SUBMIT THIS FORM TO THE CHARTER SCHOOL YOU WISH TO ATTEND.
Parent/Guardian Signature:

Clear
Date

Month Day Year
Date
Should be Empty:

SECTION A: STUDENT & PARENT/GUARDIAN INFORMATION