Vineland Public Charter School
Initial Registration Form

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Name of Student (Last Name, First Name, Middle Name) *
Address (Street, City, State, Zip): *
What school year do you want to enroll your child? *
What grade is your child currently? *
Gender: *
Date of Birth *
* Pre-K 3 students must be October 1, 2017 or earlier                                                                                                                                 * Pre-K 4 students must be October 1, 2016 or earlier                                                                                                                                 * Kindergarten students must be October 1, 2015 or earlier
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Name of Person Registering *
Relationship to Student *
Home Phone #: *
Cell Phone #: *
Email Address: *
How did you hear about our school? *
Were you referred by a current family of a VPCS student? *
If yes to the previous question, what is their name?
Does your child have siblings currently at Vineland Public Charter School? *
If yes to the previous question, what is/are their name(s) *
What is the name of the current school district your child attends? *
Did you home school this student during 2020 - 2021 school year: *
Did this student attend private school during 2020 - 2021 school year: *
If applicable, name of private school:
If applicable, address of private school
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