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Robert A. Millikan Affiliated Charter: Random Public Drawing/Lottery Application for 2019 - 2020
The following application is for a Charter Lottery Seat only. If you chose to apply to an academy, your academy application will in no way affect your odds of obtaining a seat by means of our charter lottery drawing.

If you do not have an email address, please come to the Magnet Office for a paper application.

Please do not type in ALL CAPS or all lower case. Thank you.

Upon acceptance into Millikan Middle School, a birth certificate, proof of residence and immunization records must be provided for verification. Proof of family relationship may also be required for verification. Millikan Middle School does not discriminate against any student on the basis of disability, gender, nationality, race or ethnicity, religion, sexual orientation, or any other characteristic that is contained in the definition of hate crimes set forth in Section 422.55 of the Penal Code. NO FAXES WILL BE ACCEPTED. Random Public Drawing will be held at Millikan Middle School on March 1, 2019 at 3:30 pm.

Email address *
Is the child on whose behalf you are completing this application already a student at Millikan Middle School? If so, you do not need to apply for a charter lottery seat!
Student's Last Name *
Your answer
Student's First Name (please type the legal first name of record) *
Your answer
Student's preferred first name (or nickname)
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Student's Middle Name
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Student's Date of Birth *
MM
/
DD
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YYYY
Grade Level for the 2019 - 2020 school year *
Last Name of Parent/Guardian 1 *
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First Name of Parent/Guardian 1 *
Your answer
Parent/Guardian 1 email (This is the email address we use for all future communication - Please indicate an email address that you check regularly. Do not chose an email address that blocks email. Please add jbp8974@lausd.net to your contacts.)
Your answer
Parent/Guardian 1 phone number
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Last Name of Parent/Guardian 2
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First Name of Parent/Guardian 2
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Parent/Guardian 2 email
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Parent/Guardian 2 phone number
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Home Address (123 Main Street) *
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Address line 2 (Apt., Unit, etc.)
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City
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State
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Zip Code
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Country
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A copy of your responses will be emailed to the address you provided.
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