2018-2019 Compass School Lottery Application
537 Old North Road - Kingston, RI 02881
401-788-8322 ext. 10 admin@compassschool.org
Application Deadline February 25, 2018
Student Last Name *
Your answer
Student First Name *
Your answer
Student Middle Name
Your answer
Student Date of Birth *
MM
/
DD
/
YYYY
Street Address *
Include Apt. # if applicable
Your answer
Town *
Your answer
State *
Your answer
Zip Code *
Your answer
Public School District in which your home is located *
ex: Chariho, Exeter- West Greenwich etc.
Your answer
Current Grade *
mark "N/A" if not in school
Your answer
Grade Applying for *
Parent/Guardian #1 Last Name *
Your answer
Parent/Guardian #1 First Name *
Your answer
Parent/Guardian #1 Phone Number *
Your answer
Parent/Guardian #1 Email Address *
Your answer
Parent/Guardian #1 Relation to Child *
Your answer
Parent/Guardian #2 Name
Your answer
Parent/Guardian #2 Phone Number
Your answer
Parent/Guardian #2 Email Address
Your answer
Parent/Guardian #2 Relation to Child
Your answer
Does the applicant have a brother or sister currently enrolled in this charter school? *
If yes, name of brother/sister:
Your answer
Does the applicant have a brother or sister applying to this school on a separate application? *
If yes, name of brother/sister:
Your answer
Is the applicant the child of a school founder, teacher, or staff member at this school?
If yes, name of school founder, teacher, or staff member:
Your answer
Optional Additional Information: The Compass School endeavors to increase its economically disadvantaged student population. A lottery weight will be applied to those applicants who qualify based on following criteria. Please check any/all that apply. If none apply, please leave blank.
I affirm that the information contained in this application is, to my knowledge, completely true. *
Parent Signature and Date
Your answer
I agree that my child’s school records may be used for studies on the effectiveness of public charter schools. If the studies are publicized, only group data, not student level data, will be reported. Sensitive student information will remain confidential under state and federal law. *
Note: Checking “No” will NOT affect your child’s chances for admission.
Note: Under Rhode Island law, a charter school is deemed to be a public school acting under state law and is subject to applicable provisions of federal and state law relating to non-discrimination and affirmative action, including, but not limited to, the: (1) Age Discrimination Act of 1975, 42 U.S.C. § 6101, et seq.; (2) Title VI of the Civil Rights Act of 1964, 42 U.S.C. § 2000d, et seq.; (3) Title IX of the educational amendments of 1972, 20 U.S.C. § 1681, et seq.; (4) Section 794 of Title 29, and part B of the Individuals with Disabilities Education Act, 20 U.S.C. § 1411, et seq.; (5) 42 USC, Sections 1981, 1983 and 1601 et seq.; (6) Section 504 of the Rehabilitation Act of 1973, as amended, 20 USC 794; and (8) Sections 16-38-1, 16-38-1.1, 28-5.1-13, 28-5.1-14 and Chapter 42-87 of the Rhode Island General Laws, as amended.
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