Scintilla Charter Academy 2018-2019 New Scholar Application
Post Lottery Application:
Please complete the following application as thoroughly as possible. If contact information changes, please be sure to contact the school to update that information. Please be aware that your child will be placed on the existing waiting list created during the lottery process that took place on February 5th.
Scholar's First Name: *
Your answer
Scholar's Middle Name:
Your answer
Scholar's Last Name: *
Your answer
Scholar's Preferred Name: *
Your answer
Date of Birth: *
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Age: *
Your answer
Gender *
Grade Applying For: *
Home Address: *
Your answer
City: *
Your answer
State: *
Your answer
Zip Code: *
Your answer
Does this child have a sibling who is also applying for the 2018/2019 school year? *
If Yes, please list the names & grades of all children (siblings) you are applying for. You must fill out a separate application for each child. A sibling is defined as a child who shares one or both parents. Failure to report siblings during the initial application process may prevent sibling priority.
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Full Name of Parent/Guardian: *
with whom the scholar lives
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Primary/Preferred Phone Number: *
Your answer
Relationship to Scholar: *
Your answer
E-mail Address: *
Your answer
Employer: *
Your answer
Work Phone Number:
Your answer
Cell Phone Number: *
Your answer
Full Name of Parent/Guardian #2:
Your answer
Preferred Phone Number: *
Your answer
Address:
If not the same as above
Your answer
City:
Your answer
State:
Your answer
Zip:
Your answer
Relationship to Scholar: *
Your answer
E-mail Address:
Your answer
Employer:
Your answer
Work Phone Number:
Your answer
Cell Phone Number:
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Alternative Contact Name: *
Please provide any alternative contact you would like us to reach out to should your child be offered a spot and we are unable to reach you.
Your answer
Alternative Contact's Relationship to Scholar: *
Your answer
Alternative Contact's Preferred Phone Number: *
Your answer
By signing below, I acknowledge that I have the legal right to enroll this child in school. I also acknowledge that this application does not guarantee admission to Scintilla Charter Academy and that I have read and understand the enrollment, lottery, & wait list procedures for the 2018-2019 school year. *
Please type your name below--this will serve as your official signature. Enrollment, lottery & wait list procedure can be found at http://www.scintillacharteracademy.com/enroll-at-sca.html.
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