Millville Public Charter School
Initial Registration Form
2024 - 2025 Current School Year and 2025 - 2026 Next School Year
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School Year: *
Name of Student (Last Name, First Name, Middle Name) *
Address (Street, City, State, Zip): *
Grade Entering August 2024 (2025 for next school year) *
Gender: *
Date of Birth *
*Kindergarten students must be October 1, 2020 or earlier.  
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Name of Person Registering *
Relationship to Student *
Home Phone #: *
Cell Phone #: *
Email Address: *
Did this student attend private school during 2023 - 2024 school year: *
If applicable, name of private school:
If applicable, address of private school
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