Pacific Elementary School 2017-18 Wait List Application for Interdistrict Transfer Students
NOTE: Pacific Elementary School is currently anticipating having openings for 3rd, 4th, 5th, and 6th grades in the 5-day program. If you are interested, complete this form AND contact Molly Tierney 831-425-7002 or mtierney@pacificesd.org.

Use this form to add your student to our wait list for the 2017-18 school year. Please complete a separate form for each student. Students currently enrolled in Pacific Elementary School or Pacific Preschool do NOT need to use this form, but DO need to complete other paperwork. Unenrolled siblings of current students DO need to use this form.

All forms which were submitted by Friday, February 10, 2017, were included in our lottery. The lottery was held at a meeting of the Board of Trustees on Thursday, February 16, 2017. All families completing this form AFTER February 10, 2017, will be added to the end of the wait list created by the lottery results, in order by date of inquiry.

The lottery application form for the 2018-19 school year is not yet available.

Email address
Student's last name
Your answer
Student's first name and middle initial
Your answer
Child's date of birth
MM
/
DD
/
YYYY
Student's physical street address
Your answer
Desired grade for 2017-18
Desired program (check one or both)
Required
Parent 1 first and last name
Your answer
Parent 1 phone number(s)
Your answer
Parent 1 best email address
Your answer
Parent 2 first and last name
Your answer
Parent 2 phone number(s)
Your answer
Parent 2 best email address
Your answer
For information purposes only and for the sole purpose of determining capacity and space issues which would require the creation of a new program or service, has your student or does your student currently receive special education or other special services?
Does your student have a sibling who is currently enrolled in Pacific School and will be enrolled in 2017-18?
Is either parent active-duty military personnel?
A copy of your responses will be emailed to the address you provided.
Please complete the captcha before submitting the form.
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