Benito Juarez Elementary Enrollment Application Form
Congratulations!

You are about to complete Benito Juarez Elementary Enrollment Application Form for the 2018-19 school year..

The application period for the 18-19 school year is from November 1 2017 - February 16, 2018. If no lottery is needed due to space constraints, you will receive your acceptance letter, materials and next steps the week of February 23rd. If a lottery is needed, you will be informed of the date and time.

Call or visit us with questions at 1450 Marina Way South, Richmond CA 94804, (510)215-7009.

Thank you,
Benito Juarez Elementary Administration

If you intended to enroll at another one of our AMPS schools, please click the link below and you will be redirected to our website:
https://amps-ca.schoolloop.com/apply

Student First Name *
Nombre del Estudiante
Your answer
Middle Name
Segundo Nombre
Your answer
Last Name *
Apellido
Your answer
Date of Birth *
Fecha de Nacimiento
MM
/
DD
/
YYYY
Gender *
Street Address *
Calle
Your answer
City, State, Zip Code *
Ciudad, Estado, Codigo Postal
Your answer
Home Phone Number (***) *** - **** *
Numero de Casa
Your answer
Cellular Phone Number (***) *** - **** *
Numero de Celular
Your answer
Grade for 2018-2019 School Year
Grado durante el 2018-2019 año escolar
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