Lottery Application 2018-2019
Please complete one (1) application per child and select one (1) campus only.
Email address *
Today's Date *
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Student Age by September 1, 2018 *
Your answer
Student Name *
Your answer
Date of Birth *
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Grade Level as of June 2018: *
Your answer
Grade Level Applying For: *
Complete Home Address *
Your answer
Indicate Campus Preference (Submit to one campus only or your application will be rejected) *
Mother/Legal Guardian Name
Your answer
Mother/Legal Guardian Phone Number
Your answer
Father/Legal Guardian Name
Your answer
Father/Legal Guardian Phone Number
Your answer
Does the child reside with one of the persons named above? If no, please include name, contact information and relationship to the child.
Your answer
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This form was created inside of Two Dimensions Charter School.