Mallard Creek STEM Academy 2019-2020 Application
The deadline to apply for the Admissions Lottery has passed. Your application will be entered onto the appropriate wait list.
Grade applying For the 2019-2020 School Year *
Current Grade Level *
Charter School Priority: Is the applicant currently attending a NC Charter School?
Is the applicant a brother or sister of a CURRENT MCSA Student *
Student's First Name *
Your answer
Please list names of any currently enrolled siblings at MCSA
Your answer
Student's Middle Name
Your answer
Student's Last Name *
Your answer
Student Birthdate *
MM
/
DD
/
YYYY
Primany Parent/Guardian Contact Name *
Your answer
Contact Phone Number *
Your answer
E-mail *
Enter N/A if you do not have one.
Your answer
Street Address *
Your answer
City *
Your answer
Zip *
Your answer
If your students are twins or triplets please list their names here. **Please submit one application for each student. **
Your answer
First Name of Mother/Guardian
Your answer
Last Name of Mother/Guardian
Your answer
Mother/Guardian Phone Number
Your answer
Mother/Guardian Email
Your answer
First Name of Father/Guardian
Your answer
Last Name of Father/Guardian
Your answer
Father/Guardian Phone
Your answer
Father/Guardian Email
Your answer
If any information on this application is falsified, the applicant's name will be taken out of the lottery, removed from the wait list, or removed from enrollment at the time the information is found to be inaccurate. This includes, but not limited to, information pertaining to a student's current grade level or Date of Birth. *
Required
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