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Liberty Charter School
Lottery Waiting List Application
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Child's First Name
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Your answer
Child's Last Name
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Your answer
Child's Age
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Child's Grade For 2026-2027 School Year
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PreSchool
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Child's Date of Birth
*
MM
/
DD
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YYYY
My Child is currently a student at Legacy Charter School?
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Yes
No
SIBLINGS CURRENTLY ENROLLED (MUST BE RELATED BY BIRTH, MARRIAGE, ADOPTION, FOSTER OR GUARDIANSHIP STATUS AND LIVING IN THE SAME HOUSEHOLD(S). (LEGAL DOCUMENTATION MAY BE REQUIRED)
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Non-enrolled siblings also on the waiting list:
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In order to better serve your child please let us know if he/she is currently on an IEP or other special needs program.
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Has your child previously been expelled from a school?
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Yes
No
Is your child reading at or near grade level?
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I understand LCS does not socially promote students (Please acknowledge with Initials)
*
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Mother's First Name
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Mother's Last Name
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First Phone Number
*
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Father's First Name
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Father's Last Name
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Second Phone Number
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Street Address
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City
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State
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Zip Code
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E-mail Address
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