4th Grade Wait List Registration Form 2021-2022
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Registration for the 2021-2022 Wait List Instructions:
4th Grade Registration 2021-2022 Wait List Instructions:

Applications are accepted after the lottery drawing, names will be placed on the wait list in the order they are received by the school.

Registration for the 2021-2022 Wait List Instructions:

1. Complete form only for new students applying for the Wait-List (Not for current students already attending PCCS).
2. Parents/Guardian must electronically complete/submit or come to the office for a paper form(forms can be mailed upon request).
3. Contact Janette Siegel @ 847-548-1938 or via email  jsiegel@pccharterschool.org once you have submitted your form to confirm it was received.
4.  If your child is called for an open seat during the current school year and you would like to accepted you are required to send in 3 Proofs of Residency(Utility Bill, Rental Agreement, Tax Bill) and a certified copy of your child's Birth Certificate (note that your child must be 5 years of age on or before Sept 1st in order to enter Kindergarten) within 3 days of accepting the open seat.

Admission is on a non-discriminatory basis and open to all students regardless of race, ethnicity, gender, socioeconomic status, sexual orientation, religious preference or disability.  Prairie Crossing Charter School provides a full complement of services for students with disabilities, students with Limited English Proficiency, and offers transportation assistance for all students via carpools and private services. Instructional fee waivers are available for families whose income level qualifies based upon federal standards provided by the U.S. Department of Agriculture. We are a free public school that provides a personalized Kindergarten through 8th Grade education for students that reside in the Woodland (50) and Fremont (79) Districts.

The wait-list is maintained on our website.  Please refer to the 2021-2022 wait-list when checking for updates.

Applicant's Last Name *
Applicant's First Name *
Applicant's Middle Name
Applicant's Date of Birth *
Applicant's District of Residence *
I am confirming what school district I reside in.  Please provide the district name and number. *
I am confirming that for the 2021-2022 school year my child will be entering: *
Do you currently have a child/children attending Prairie Crossing Charter School? *
Do you  have other children applying for the Wait List? Please fill out a separate form for each child applying. *
If you  have other children applying for the Wait List, please provide their name and grade level for the 2021-2022 school year *
Father's Name *
Father's Address (street, city and zip code) *
Father's Cell Phone *
Father's Home Phone *
Father's Email Address *
Mother's Name *
Mother's Address *
Mother's Cell Phone *
Mother's Home Phone *
Mother's Email Address *
Where did you hear about Prairie Crossing Charter School?
By checking this box, I confirm and agree that all of the information provided on this document is true and accurate.   *
A copy of your responses will be emailed to the address you provided.
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