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) *
Your answer
Please type your phone number (the person filling out this form) *
Your answer
About the student
Student's first name - LEGAL NAME *
Your answer
Student's first name - PREFERRED NAME or NICKNAME *
What name does your student like teachers to call him or her?
Your answer
Student's last name *
Your answer
If the student has a phone number, please list it here. Otherwise, please leave this question blank.
Your answer
Student shirt size *
Student pants size *
Student shoe size *
What is the student's favorite subject? *
Your answer
What is the student's favorite movie or TV show? *
Your answer
What is the student's favorite book? *
Your answer
What is the student's favorite song, artist, or band? *
Your answer
What is the student's favorite sports team? *
Your answer
What does the student enjoy doing when he or she is not in school? *
Your answer
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.
Your answer
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.
Your answer
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.
Your answer
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.
Your answer
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.
Your answer
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.
Your answer
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.
Your answer
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.
Your answer
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.
Your answer
If applicable: Mother / Legal Guardian occupation (otherwise, leave blank):
Your answer
If applicable: Mother / Legal Guardian name of employer (otherwise, leave blank):
Your answer
If applicable: Mother / Legal Guardian employer phone number / business phone number (otherwise, leave blank):
Your answer
If applicable: Father / Legal Guardian occupation (otherwise, leave blank):
Your answer
If applicable: Father / Legal Guardian name of employer (otherwise, leave blank):
Your answer
If applicable: Father / Legal Guardian employer phone number / business phone number (otherwise, leave blank):
Your answer
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.
Your answer
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.
Your answer
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.
Your answer
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.
Your answer
If applicable, please list special medical issues. Otherwise, please leave this question blank.
Your answer
If applicable, please list any allergies of the student. Otherwise, please leave this question blank.
Your answer
Listed healthcare provider
Your answer
Listed healthcare provider phone number
Your answer
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.
Your answer
Transportation
How do you anticipate your student will leave school each day?
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)
Your answer
(if applicable) - Person 1, relationship to child: (otherwise, leave blank)
Your answer
(if applicable) - Person 1, cell phone and alternative phone: (otherwise, leave blank)
Your answer
(if applicable) - Person 2, name: (otherwise, leave blank)
Your answer
(if applicable) - Person 2, relationship to child: (otherwise, leave blank)
Your answer
(if applicable) - Person 2, cell phone and alternative phone: (otherwise, leave blank)
Your answer
(if applicable) - Person 3, name: (otherwise, leave blank)
Your answer
(if applicable) - Person 3, relationship to child: (otherwise, leave blank)
Your answer
(if applicable) - Person 3, cell phone and alternative phone: (otherwise, leave blank)
Your answer
(if applicable) - Person 4, name: (otherwise, leave blank)
Your answer
(if applicable) - Person 4, relationship to child: (otherwise, leave blank)
Your answer
(if applicable) - Person 4, cell phone and alternative phone: (otherwise, leave blank)
Your answer
(if applicable) - Person 5, name: (otherwise, leave blank)
Your answer
(if applicable) - Person 5, relationship to child: (otherwise, leave blank)
Your answer
(if applicable) - Person 5, cell phone and alternative phone: (otherwise, leave blank)
Your answer
(if applicable) - Person 6, name: (otherwise, leave blank)
Your answer
(if applicable) - Person 6, relationship to child: (otherwise, leave blank)
Your answer
(if applicable) - Person 6, cell phone and alternative phone: (otherwise, leave blank)
Your answer
(if applicable) - Person 7, name: (otherwise, leave blank)
Your answer
(if applicable) - Person 7, relationship to child: (otherwise, leave blank)
Your answer
(if applicable) - Person 7, cell phone and alternative phone: (otherwise, leave blank)
Your answer
Submit
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