NECCS ENROLLMENT INTEREST FORM
Thank you for your interest in Newark Educators Community Charter School! 

Please provide your contact information and our Enrollment Specialist will contact you shortly.
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Parent/Guardian First Name *
Parent/Guardian Last Name *
Please provide your residential address.  *
Contact Number *
Email *
What is your preferred method of communication? *
What grade(s) are you interested in?  *
Required
How many scholars would you be enrolling in NECCS? *
Please tell us how you heard about us?  *
If you answered "Yes" or "Other" for the above question, please provide details
What school year are you interested in? *
A representative from Newark Educators will get in contact with you shortly.               
THANK YOU FOR YOUR TIME 
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