2018-2019 Pacific Elementary School Lottery Application for Interdistrict Transfer Students
To be included in the 2018-19 lottery you must have completed this form BY FRIDAY, FEBRUARY 9, 2018. Now you may use this form to express interest in attending for the 2018-2019 school year. Please complete a separate form for each student.

NOTE: As of July 2018, Pacific Elementary School has openings in kindergarten, second, fifth, and sixth grades in the 5-day program and all grades in the Independent Study Program. We also have openings in Preschool, which has a separate interest form which can be found on our website. Please do NOT use this form for interested preschoolers.

Email address *
Student's last name *
Your answer
Student's first name and middle initial *
Your answer
Student's date of birth *
MM
/
DD
/
YYYY
Student's physical street address *
Your answer
Desired grade for 2018-2019 (preschool has a separate form which can be found on our website) *
Desired program (check one or both) *
Required
Parent 1 first and last name *
Your answer
Parent 1 phone number(s) *
Your answer
Parent 1 best email address *
Your answer
Parent 2 first and last name
Your answer
Parent 2 phone number(s)
Your answer
Parent 2 best email address
Your answer
How did you hear about Pacific Elementary School? (choose as many as apply) *
Required
Why are you interested in enrolling your child at Pacific Elementary School? *
Your answer
The following question is for information purposes only and for the sole purpose of determining capacity and space issues which would require the creation of a new program or service. Has your student ever been assessed for, recommended to receive, received in the past, or currently receive any of the following? *
Required
The following question is for information purposes only and for the sole purpose of determining capacity and space issues which would require the creation of a new program or service. Has your student ever been assessed for, recommended to receive, received in the past, or currently receive any of the following? *
Required
Does your student have a sibling who is currently enrolled in Pacific School and will be enrolled in 2018-19? *
Is either parent active-duty military personnel?
A copy of your responses will be emailed to the address you provided.
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