2018-19 Democracy Prep Congress Heights Online Registration Form
Email address *
Accepted Students Instructional Placement Disclaimer:
Our goal at Democracy Prep is to prepare each of our students for the path to college. To fulfill this goal, it is necessary for us to appropriately and realistically evaluate where our students are academically when they enroll at Democracy Prep.

We are committed to recruiting and serving all children, including those students with special needs and English Language Learners. Democracy Prep accepts new scholars at all grade levels (K-8) at the beginning of each new academic year by random lottery when space is available. Acceptance guarantees the accepted student a seat in the grade that is most appropriate for the student’s level of academic ability but does not guarantee a student’s acceptance to a particular grade regardless of age or prior grade completion.

As such, after a student is accepted to one of our schools based on our random lottery, the student takes an academic assessment which serves to let us know the appropriate grade level in which to place the student based on our rigorous college preparatory curriculum. Even if a student initially is placed in an upper grade, a scholar can be retained at any time if the student does not meet the DPPS promotion criteria. We do provide extra support to scholars in the form of after school tutoring, Saturday school and summer school to ensure that our scholars succeed at Democracy Prep, in college, in civic life and beyond.

Democracy Prep’s ability to appropriately evaluate and serve each scholar is highly dependent on any Individualized Education Programs (IEPs) and special learning needs. In any instance in which Democracy Prep is unable to serve a student in an appropriate manner, a discussion will occur with each family to find at the most appropriate match for the student’s needs. We will try our best to serve each student and their needs to the best of our ability with the resources available to us.

While it may take some scholars longer than others, at Democracy Prep we are committed to preparing all scholars for success in the college of their choice and a life of active citizenship and we ask that our parents partner with us in this extraordinary endeavor.

I have read the above "Accepted Students Instructional Placement Disclaimer" and I accept its terms and conditions. *
Scholar Information
The following information pertains to the REGISTERING SCHOLAR.
Last Name *
Your answer
First Name *
Your answer
Date of Birth *
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DD
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YYYY
Enrolling Grade *
Please indicate whether your scholar has an IEP or receives related services at school. Be sure to bring a copy of the IEP, 504 plan and any evaluations with you to your enrollment meeting.
Primary Guardian Information
The following information pertains to the primary guardian with whom the scholar lives with.
Relationship to Scholar *
Your answer
Last Name *
Your answer
First Name *
Your answer
Street Address *
Your answer
City & State *
Your answer
Zipcode *
Your answer
Ward *
Your answer
Primary Phone Number *
Your answer
Secondary Phone Number *
Your answer
Secondary Guardian Information
Please use this section to add a secondary guardian or emergency contact
Relationship to Scholar
Your answer
Last Name
Your answer
First Name
Your answer
Street Address
Your answer
City & State
Your answer
State
Your answer
Zipcode
Your answer
Ward
Your answer
Primary Phone Number
Your answer
Secondary Phone Number
Your answer
Email Address
Your answer
Ethnic Identification Form
All students between the age of 5 and 21 years of age have the right to a free public education. Children may not be refused admission to a public school because of race, color, creed, national origin, gender identity, pregnancy, immigration/citizenship status, disability, sexual orientation, religion, or ethnicity.


Is the scholar Hispanic, Latino, or of Spanish origin?
Select one or more races from the following five racial groups.
Transportation Information
This section provides information to the school about how your child will arrive and depart on a daily basis.
What mode of transportation are you using to get your child to/from school? *
If your child attends an offsite aftercare, what is the name of the aftercare provider?
Your answer
What is the phone number of the offsite aftercare provider?
Your answer
If your child does not self-transport, who will be picking him/her up on a daily basis?
Name of person(s) authorized to pick student up
Your answer
My scholar will be attending aftercare with Springboard, DPCH's in-house aftercare program. *
Medical Information
Please answer the following questions about your scholar.
Does your scholar have any dietary restrictions? *
Your answer
Does your scholar have any allergies? Check all that apply. *
Required
If you answered "other" to the above question, please provide an explanation.
Your answer
Does your scholar have any medical conditions we need to know about? *
If you answered "yes" to the question above, please provide an explanation.
Your answer
Does your scholar have any medications that will need to be administered here at Democracy Prep? *
If you answered "Yes" to the question above, have you submitted a physician signed "Medical Administration Form"?
Seat Accepted Form
As a DPPS Scholar, I pledge that I will:

★ Attend Prep Academy in August 2018.
★ Attend school from August to June without exceptions or excuses.
★ Arrive promptly to school, Mon-Friday, five minutes before the agreed upon start time in the appropriate uniform, prepared, rested, enthusiastic and ready to learn until dismissal.
★ Attend Saturday and/or Summer Academy from 8:30AM to 1:00PM, as required.
★ Always give my best effort in every class and keep trying in everything until I succeed.
★ Do all my homework, study for all tests and never let failure stop me from moving forward.
★ Always strive to attain the DREAM Values of Democracy Prep (Discipline, Respect, Enthusiasm, Accountability & Maturity).
★ Always be open and honest with my teachers, family, peers and myself.
★ Always accept responsibility for my actions and learn from my mistakes.
★ Always treat my teachers, peers and myself with respect.
★ Use my gifts, talents and dedication to serve others and become an engaged citizen in my community.

As a DPPS Family, we pledge that we will:

★ Help register at least two individuals in our family or community to vote.
★ Attend family conferences and important school events.
★ Be active in our scholar’s life and help our scholar achieve their goals as they work hard, go to college and change the world!

Signature *
Your answer
A copy of your responses will be emailed to the address you provided.
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