2018-2019 Innovation Student Application
Thank you for applying to the Renaissance Charter High School for Innovation
Student's First Name *
Your answer
Student's Last Name *
Your answer
Student is applying for the *
Student Street Address: *
Your answer
City *
Your answer
State *
Zip Code *
Your answer
Does Student live in NYC Community School District 4? *
Student date of birth *
MM
/
DD
/
YYYY
Student gender *
Student's Language *
Your answer
Student's Current School *
Your answer
Student's Current Grade *
Student ID # *
Your answer
Regarding Ethnicity, how does the Student self-identify?
(Optional)
Parent 1 (Primary Contact) Information
We ask for two Parent / Contacts. This section is for the Primary contact for the student.
Parent 1 (or Primary Contact) First Name *
Your answer
Parent 1 (or Primary Contact) Last Name *
Your answer
Parent 1 (or Primary Contact) Phone Number *
Your answer
Parent 1 (or Primary Contact) Phone Number type *
Parent 1 (or Primary Contact) Email Address
Your answer
Is the Parent 1 (Primary Contact) Address the SAME as the Student? *
We ask for 2 Parent contacts. If the PRIMARY contact for this student has the same address, answer Yes
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