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San Joaquin Elementary and Middle Schools
Interest in Enrollment
Email address
Today's Date
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Parent Name:
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Phone (Home)
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Phone (Cell)
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Address
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Student Name (List additional students interested in enrolling below)
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Current Grade
Is this student on an IEP or 504 Plan?
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Name of Last School
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Reasons for choosing a blended online homeschool?
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List any questions you have
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Additional Student's Name
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Current Grade
Is this student on an IEP or 504 Plan?
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Name of Last School
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Additional Student's Name
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Current Grade
Is this student on an IEP or 504 Plan?
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Name of Last School
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Please send recent report card to lesliechartier@iusd.org
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