2019-2020 Accept Your Offer
Welcome! We are thrilled that you have an offer to enroll at Midtown! To accept your offer, please be sure to complete this form.
This form is for NEW STUDENT APPLICANTS to Midtown! If you are currently a Midtown student, please click the following link for reenrollment instructions: https://docs.google.com/forms/d/e/1FAIpQLScSuExSot5bIgTak9d7UKcgkqpYZbg4mgyBTx6kfnJ3BCx7bw/viewform
After you complete the application, please click "Submit." When you do, you should see a screen like the one pictured below. If you do not, then your application did not go through.
Please type your name (the person filling out this form) *
Please type your phone number (the person filling out this form) *
About the student
Student's first name - LEGAL NAME *
Student's first name - PREFERRED NAME or NICKNAME *
What name does your student like teachers to call him or her?
Student's last name *
If the student has a phone number, please list it here. Otherwise, please leave this question blank.
Student shirt size *
Student pants size *
Student shoe size *
What is the student's favorite subject? *
What is the student's favorite movie or TV show? *
What is the student's favorite book? *
What is the student's favorite song, artist, or band? *
What is the student's favorite sports team? *
What does the student enjoy doing when he or she is not in school? *
Is the student Hispanic/Latino? *
Which of the following is the student? Please check ALL that apply. *
Required
If applicable: Which school or schools did the student attend KINDERGARTEN? If the student did not attend a school for kindergarten, please lave blank.
If applicable: Which school or schools did the student attend for GRADE 1? If the student did not attend a school for grade 1, please lave blank.
If applicable: Which school or schools did the student attend for GRADE 2? If the student did not attend a school for grade 2, please lave blank.
If applicable: Which school or schools did the student attend for GRADE 3? If the student did not attend a school for grade 3, please lave blank.
If applicable: Which school or schools did the student attend for GRADE 4? If the student did not attend a school for grade 4, please lave blank.
If applicable: Which school or schools did the student attend for GRADE 5? If the student did not attend a school for grade 5, please lave blank.
If applicable: Which school or schools did the student attend for GRADE 6? If the student did not attend a school for grade 6, please lave blank.
If applicable: Which school or schools did the student attend for GRADE 7? If the student did not attend a school for grade 7, please lave blank.
If applicable: Which school or schools did the student attend for GRADE 8? If the student did not attend a school for grade 8, please lave blank.
If applicable: Mother / Legal Guardian occupation (otherwise, leave blank):
If applicable: Mother / Legal Guardian name of employer (otherwise, leave blank):
If applicable: Mother / Legal Guardian employer phone number / business phone number (otherwise, leave blank):
If applicable: Father / Legal Guardian occupation (otherwise, leave blank):
If applicable: Father / Legal Guardian name of employer (otherwise, leave blank):
If applicable: Father / Legal Guardian employer phone number / business phone number (otherwise, leave blank):
If applicable: Please check
If applicable - In the case of divorce and separate: Who has legal custody? If not applicable, please leave this question blank.
If applicant is not living with both parents, please indicate with whom the child resides. If the applicant is living with both parents, please leave this question blank.
Please list the first name, middle name, last name, and date of birth (including year) for each of the student's siblings. If the applicant does not have any siblings, please leave this question blank.
Does the student currently receive any of the following services? If applicable, please check ALL that apply.
What was the language the student first learned to speak? (First Language) *
What language does the student speak at home? (Home Language) *
What language does the student speak most often? (Primary Language) *
Please select one of the following. *
Medical Information
Physician documentation required
Does the student need to take medication at school (only physician prescribed) *
If the student needs to take medication at school (only physician prescribed) - Please list the medication. Otherwise, please leave this question blank.
If applicable, please list special medical issues. Otherwise, please leave this question blank.
If applicable, please list any allergies of the student. Otherwise, please leave this question blank.
Listed healthcare provider
Listed healthcare provider phone number
In the event of a medical emergency, MPCS will have the student transported to the closest doctor or medical facility for treatment. Parents/guardians will assume full responsibility for all charges incurred. If you have a preference for a particular hospital to transport your student in case of an emergency, please list it here. Otherwise, please leave this question blank. We cannot guarantee that in the case of a medical emergency we will be able to transport your student to the preferred hospital.
Transportation
How do you anticipate your student will leave school each day?
Clear selection
Emergency / Authorized Pick Up
The following person(s) may pick my child(ren) up from school and may also be called in case of emergency if the enrolling adult cannot be reached.
(if applicable) - Person 1, name: (otherwise, leave blank)
(if applicable) - Person 1, relationship to child: (otherwise, leave blank)
(if applicable) - Person 1, cell phone and alternative phone: (otherwise, leave blank)
(if applicable) - Person 2, name: (otherwise, leave blank)
(if applicable) - Person 2, relationship to child: (otherwise, leave blank)
(if applicable) - Person 2, cell phone and alternative phone: (otherwise, leave blank)
(if applicable) - Person 3, name: (otherwise, leave blank)
(if applicable) - Person 3, relationship to child: (otherwise, leave blank)
(if applicable) - Person 3, cell phone and alternative phone: (otherwise, leave blank)
(if applicable) - Person 4, name: (otherwise, leave blank)
(if applicable) - Person 4, relationship to child: (otherwise, leave blank)
(if applicable) - Person 4, cell phone and alternative phone: (otherwise, leave blank)
(if applicable) - Person 5, name: (otherwise, leave blank)
(if applicable) - Person 5, relationship to child: (otherwise, leave blank)
(if applicable) - Person 5, cell phone and alternative phone: (otherwise, leave blank)
(if applicable) - Person 6, name: (otherwise, leave blank)
(if applicable) - Person 6, relationship to child: (otherwise, leave blank)
(if applicable) - Person 6, cell phone and alternative phone: (otherwise, leave blank)
(if applicable) - Person 7, name: (otherwise, leave blank)
(if applicable) - Person 7, relationship to child: (otherwise, leave blank)
(if applicable) - Person 7, cell phone and alternative phone: (otherwise, leave blank)
Submit
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