LEAD Charter School Student Application
LEAD Charter School is now enrolling young people who are between 16-21 years old and have attempted high school. To apply for the upcoming or current school year, please complete all fields below. We will invite you to our enrollment center for an information session. LEAD's enrollment center is located at 201 Bergen Street, Newark NJ, 07103. The enrollment center can be reached at 862-772-1724.

Filling out this application does not guarantee admission. It only guarantees inclusion in the enrollment list and process. A registration form will be required next. Visit our website at leadcharterschool.org or call 862-772-1724 for more information regarding the enrollment process.
Student Information
Email Address
Which site are you applying for? *
Student First Name *
Student Last Name *
Student Middle Name or Initial *
Student Date of Birth *
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Gender *
Age *
Street Address *
City *
If you selected "Other" for city above, please tell us what city you're from.
State *
Zip Code *
Home Phone Number *
Last Grade Attempted *
What was the last school that you attended? *
Do you currently have a sibling attending LEAD Charter School? *
If you currently have a sibling(s) that currently attend LEAD Charter School, list the name(s) below. (Enrollment preference is given to siblings of enrolled students per N.J.S.A 36A-8c) Type N/A if this does not apply to you. *
What is your relationship to the applicant listed on this form? *
Parent/Guardian Information (Required if under 18 years old)
Guardian #1 First Name
Guardian #1 Last Name
Guardian #1 Relationship to Applicant
Guardian #1 Phone Number
Guardian #1 Alternate Phone Number
Guardian #1 Email Address
Guardian #2 First Name
Guardian #2 Last Name
Guardian #2 Relationship to Applicant
Guardian #2 Phone Number
Guardian #2 Alternate Phone Number
Guardian #2 Email Address
Signatures
Parent/Guardian Signature (typed) - required only if the student is younger than 18 years of age
Date of Parent/Guardian Signature
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Student Signature (typed) - required only if the student is younger than 18 years of age *
Date of Student Signature
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Enter referral code, if applicable.
Submit
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