Memphis School of Excellence - Cordova Interest Survey
MSE plans to open two new K-5 and 6-12 schools in Cordova. Please complete this form to indicate your interest in enrolling a student for the 2020-2021 school year. The school opening is contingent on the approval of the Memphis School of Excellence Cordova by the Shelby County Schools.
*Submission of this form is not an application for enrollment and does not guarantee enrollment. This is an interest survey only.
**Please Fill out one form for each interested student.
email address (optional)
Your answer
Student's first & last name *
Your answer
Student's Date of birth *
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1st Parent/Guardian First and Last Name *
Your answer
2nd Parent/Guardian First and Last Name
Your answer
Home/Cell Phone # *
Your answer
Alternative Phone # (optional)
Your answer
Address *
Your answer
City, State, Zip *
Your answer
Student's grade for 2020-2021 *
How did you learn about MSE-Cordova? *
Comment
Your answer
NON-DISCRIMINATION STATEMENT
The Memphis School of Excellence (MSE) does not discriminate on the basis of race, religion, creed, sex, gender, gender identity, sexual orientation, national origin, color, age, and/or disability in admission to, access to, or operation of its programs, services, or activities, and provides access to youth groups. MSE does not discriminate in its hiring or employment practices.
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