2017-2018 IC Imagine Enrollment Application
Email address
Number of School Age Children in Family Applying (Please read below for the definition of sibling for these purposes)
For the purposes of this section, the term "siblings" includes any of the following who reside in the same household: half siblings, step-siblings, and children residing in a family foster home. If siblings apply for admission to a charter school and a lottery is needed, the charter school may enter one surname into the lottery to represent all of the siblings applying at the same time. If that surname of the siblings is selected, then all of the siblings shall be admitted to the extent that space is available and does not exceed the grade level capacity. If multiple birth siblings apply for admission to a charter school and a lottery is needed, the charter school shall enter one surname into the lottery to represent all of the multiple birth siblings applying at the same time. If that surname of the multiple birth siblings is selected, then all of the multiple birth siblings shall be admitted.
Student 1 - First Name
Your answer
Student 1 - Middle Name
Your answer
Student 1 - Last Name
Your answer
Student 1 - Date of Birth
Students entering Kindergarten must be born on or before August 31, 2012. Applicants who are not the appropriate age for the grade they will be entering must have previous school documentation of a change in grade level.
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Student 1 - Current Grade Level 2016-2017 School Year
Student 1 - Grade Level Rising to 2017-2018 School Year
Student 2 - First Name
Your answer
Student 2 - Middle Name
Your answer
Student 2 - Last Name
Your answer
Student 2 - Date of Birth
Students entering Kindergarten must be born on or before August 31, 2012. Applicants who are not the appropriate age for the grade they will be entering must have previous school documentation of a change in grade level.
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DD
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Student 2 - Current Grade Level 2016-2017 School Year
Student 2 - Grade Level Rising to 2017-2018 School Year
Student 3 - First Name
Your answer
Student 3 - Middle Name
Your answer
Student 3 - Last Name
Your answer
Student 3 - Date of Birth
Students entering Kindergarten must be born on or before August 31, 2012. Applicants who are not the appropriate age for the grade they will be entering must have previous school documentation of a change in grade level.
MM
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DD
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YYYY
Student 3 - Current Grade Level 2016-2017 School Year
Student 3 - Grade Level Rising to 2017-2018 School Year
Student 4 - First Name
Your answer
Student 4 - Middle Name
Your answer
Student 4 - Last Name
Your answer
Student 4 - Date of Birth
Students entering Kindergarten must be born on or before August 31, 2012. Applicants who are not the appropriate age for the grade they will be entering must have previous school documentation of a change in grade level.
MM
/
DD
/
YYYY
Student 4 - Current Grade Level 2016-2017 School Year
Student 4 - Grade Level Rising to 2017-2018 School Year
Is this student a child of a current IC Imagine Faculty Member?
If Yes, give name of the faculty member.
Please give first and last name.
Your answer
Is this student a sibling of a currently enrolled IC Imagine Champion?
If yes, provide name of currently enrolled sibling
Please include first and last name.
Your answer
Parent 1 - First Name
Your answer
Parent 1 - Last Name
Your answer
Parent 1 - Street/Mailing Address
Your answer
Parent 1 - City
Your answer
Parent 1 - State
You must be a resident of NC at the time of application.
Parent 1 - Zip Code
Your answer
Parent 1 - Email Address
Your answer
Parent 1 - Confirm Email Address
Your answer
Parent 1 - Cell Phone Number
Your answer
Parent 1 - Home Phone Number
Your answer
Parent 1 - Work Phone Number
Your answer
Parent 2 - First Name
Your answer
Parent 2 - Last Name
Your answer
Parent 2 - Street/Mailing Address
Your answer
Parent 2 - City
Your answer
Parent 2 - State
You must be a resident of NC at the time of application.
Parent 2 - Zip Code
Your answer
Parent 2 - Email Address
Your answer
Parent 2 - Confirm Email Address
Your answer
Parent 2 - Cell Phone Number
Your answer
Parent 2 - Home Phone Number
Your answer
Parent 2 - Work Phone Number
Your answer
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