Registration Form 2018-2019 For New Students to Beekman Charter School ONLY
Beekman Charter School is a free, public charter school that does not discriminate on the basis of race, creed, national origin, ethnicity, religion, gender, sexual orientation, mental or physical disability, special needs, English language proficiency, athletic ability, or academic achievement. If you falsify any information, your application will be voided.
Student’s Legal First Name *
Your answer
Student’s Legal Middle Name *
Your answer
Student’s Legal Last Name *
Your answer
Birth Date *
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DD
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YYYY
Gender *
Street Address *
Your answer
City *
Your answer
State *
Your answer
Home Phone Number *
Your answer
Language spoken at home
Your answer
Language most often spoken by student
Your answer
Grade Placement for the 2018-2019 School Year *
Your answer
Current School
Your answer
School Address
Your answer
School City, State, Zip Code
Your answer
Please list the names and grades of siblings and what school each attends.
Your answer
Female Parent/Guardian’s First Name
Your answer
Female Parent/Guardian’s Last Name
Your answer
Relationship to Student
Your answer
Employer
Your answer
Female Parent/Guardian’s Work Phone
Your answer
Female Parent/Guardian’s Cell Phone
Your answer
Female Parent/Guardian’s Email Address
Your answer
Male Parent/Guardian’s First Name
Your answer
Male Parent/Guardian’s Last Name
Your answer
Relationship to Student
Your answer
Employer
Your answer
Male Parent/Guardian’s Work Phone
Your answer
Male Parent/Guardian’s Cell Phone
Your answer
Male Parent/Guardian’s Email Address
Your answer
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