2022-2023 Student Application Form

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Please fill out the application information below. If your requested grade level has openings, someone from YCS will be in contact with you to complete the registration process. If there are no current openings in your requested grade level, you will be put on a waitlist, and you should seek other options. If you are new to the school, we will need the child's birth certificate, shot record, custody papers (if applicable) and 2 proofs of residency, and parent driver's license/state i.d.

Email *

Name of Child *

Male/Female *

Male

Female

Child's birthday *

Address *

Mother's full name *

Mother's phone number *

Father's full name *

Father's phone number *

What grade is the child entering *

Kindergarten

First grade

Second grade

Third grade

Fourth grade

Fifth grade

Sixth grade

Seventh grade

Eighth grade

Is your child currently enrolled in YCS? *

Yes

Does the child have siblings at YCS? *

Yes

If yes, please list siblings and grades

Has your child ever been retained? *

Yes

If yes, in what grade was your child retained

What other schools has your child attended. Please list school, city and grade.

Is your child currently in a SPECIAL NEEDS PROGRAM with an ETR and IEP? *

Yes

I don't know

If yes, where is your child in the special needs program?

If you child is in a special needs program, what program?

Specific Learning Disability (SLD)

Intellectual Disability (ID)

Emotional Disturbance (ED)

Other Health Impaired (OHI)

Speech and Language (SLP)

Multiple Disabilities (MD)

Other

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How did you hear about Youngstown Community School?

Name of person filing out the form *

Relationship to student *

Date *

YYYY

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