2017-18 REALMS Lottery Application
Use this application to apply for REALMS for the 2017-18 school year. Please type carefully - your address, phone number and email address will be used to contact you after the lottery!
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STUDENT INFORMATION
Student First Name (legal name) *
Student Last Name (legal name) *
CURRENT Grade (in 2016-17 school year). Do NOT put in the student's grade for next year. *
Current School *
Why do you think REALMS will be a good learning environment for your son/daughter? *
PARENT ONE INFORMATION
for parent completing this application - required
Parent 1 First Name *
Parent 1 Last Name *
Parent 1's Relationship to student *
Parent 1 Mailing Address - STREET *
include apt # if necessary or PO Box
Parent 1 Mailing Address - CITY *
ex. Bend
Parent 1 Mailing Address - STATE *
ex. OR
Parent 1 Mailing Address - ZIP *
Parent 1 Home Phone
Parent 1 Cell Phone
Parent Email Address
we will use this most often for communication!
PARENT TWO INFORMATION
use this OPTIONAL section to add a 2nd parent
Parent 2 First Name
Parent 2 Last Name
Parent 2's Relationship to student
Parent 2 Mailing Address - STREET
Parent 2 Mailing Address - CITY
Parent 2 Mailing Address - STATE
Parent 2 Mailing Address - ZIP
Parent 2 Home Phone
Parent 2 Cell Phone
Parent 2 Email address
we will use this often for communication
ADDITIONAL PARENT/GUARDIAN INFORMATION
Use this section add a 3rd parent/guardian who should be informed about lottery results.
Additional Parent First Name
Additional Parent Last Name
Additional Parents's Relationship to student
Additional Parent Mailing Address
Additional Parent - City
Additional Parent - State
Additional Parent - Zip code
Additional Parent - Home Phone
Additional Parent - Cell Phone
Additional Parent - Email address
FINAL DETAILS
Has one or more parents/guardians attended (or are you planning to attend) one of our Information Nights? *
February 23rd @ 6pm and February 28th @ 6pm
If you answered yes above, please explain:
DON'T FORGET TO HIT SUBMIT!
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