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Millville Public Charter School
Initial Registration Form
2022 - 2023 School Year and 2023 - 2024 School Year
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* Required
School Year:
*
Current School Year (2022-2023)
Next School Year (2023-2024)
Name of Student (Last Name, First Name, Middle Name)
*
Your answer
Address (Street, City, State, Zip):
*
Your answer
Grade Entering August 2023
*
Kindergarten
First Grade
Second Grade
Third Grade
Fourth Grade
Fifth Grade
Sixth Grade
Seventh Grade
Eighth Grade
Gender:
*
Female
Male
Date of Birth
*
*Kindergarten students must be October 1, 2018 or earlier.
MM
/
DD
/
YYYY
Name of Person Registering
*
Your answer
Relationship to Student
*
Your answer
Home Phone #:
*
Your answer
Cell Phone #:
*
Your answer
Email Address:
*
Your answer
Did this student attend private school during 2022 - 2023 school year:
*
Yes
No
If applicable, name of private school:
Your answer
If applicable, address of private school
Your answer
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