Enrollment Application, 2019-2020
For New Students
Email address *
Student Name
Student Name: *
Your answer
Grade Applicant is Entering in Fall 2019: *
Custodial Family: (Primary Residence of Student)
Street Address: *
Your answer
City/State/Zip: *
Your answer
Home Phone Number: *
Your answer
Parent / Guardian 1: *
Your answer
Relation: *
Your answer
Cell Phone Number: *
Your answer
Parent / Guardian 2: *
Your answer
Relation: *
Your answer
Cell Phone Number: *
Your answer
Siblings at Passages
1. Name: *
Your answer
Grade: *
2. Name: *
Your answer
Grade: *
3. Name: *
Your answer
Grade: *
I certify that all the answers given in this enrollment application are true, accurate, and complete. I understand that if my child is enrolled, my having given false or misleading information in any of my application forms, residency forms, or having omitted significant information, may result in the discharge of my child from the school. My signature on this application signifies that, if selected in the lottery, my child will attend Passages Charter School.
Printed Name (of person who completed this form) *
Your answer
Signature Date *
Your answer
A copy of your responses will be emailed to the address you provided.
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