Lottery Enrollment for 2018/19
Please fill out this form to enter your child in the 2018/19 Lottery. The enrollment window is live on our website January 8th through February 28th. The 4th and 6th Grade Lottery will be March 7th with results posted on our website by the end of that day. It is important to note that the March 7th Lottery is for new students in 4th Grade and 6th Grade only. The current Mountain Middle School students will be completing an intent to return process that will determine how many seats will be made available in 5th-8th Grades. The lottery results will determine the wait list order for all grades. Students with exempt status must fill this form out during the enrollment window to be eligible for their exempt seat. Please fill this form out for each child you are entering into the lottery.
Student's Last Name *
Your answer
Student's First Name *
Your answer
Student Gender *
Student Date of Birth *
MM/DD/YYYY
Your answer
What grade will your student be in next school year? (2018/19) *
This is the grade level lottery you are entering your child into.
Does the student have exempt status? *
What is/are the sibling(s) name and age?
Your answer
What is the student's race? *
Please check current grade.
Please check current school. *
Does the student have an existing IEP? If Yes, Please provide a copy of the plan from your current school to the main office with your registration packet. A transition meeting is required. *
Does the student have an existing READ plan? If Yes, Please provide a copy of the plan from your current school to the main office with your registration packet. A transition meeting is required. *
Does the student have an existing 504? If Yes, Please provide a copy of the plan from your current school to the main office with your registration packet. A transition meeting is required. *
Does the student have an existing ALP? If Yes, Please provide a copy of the plan from your current school to the main office with your registration packet. *
Please explain any special medical considerations. Please describe any allergies, medications, or special medical needs.
Your answer
Has the student been expelled or suspended from school. (If yes, please explain) *
Your answer
Parent/Guardian 1 Email Address *
Lottery form and results will be sent to the email address provided
Your answer
Parent/Guardian 2 Email Address
Your answer
Student Mailing Address (Street or PO Box) *
Your answer
Student Mailing Address (City) *
Your answer
Student Mailing Address (State) *
Your answer
Student Mailing Address (Zip code) *
Your answer
Student Physical Address If different from Mailing Address
Your answer
Student Home Phone * (incl. area code) *
Your answer
Parent/Guardian 1 FULL NAME *
Your answer
Relationship to Student *
Parent/Guardian 1 Home Phone (incl. area code) * xxx-xxx-xxxx *
Your answer
Parent/Guardian 1 Mobile Phone (incl. area code) xxx-xxx-xxxx *
Your answer
Parent/Guardian 1 Work Phone (incl. area code) xxx-xxx-xxxx
Your answer
Parent/Guardian 1 Place Of Employment *
Your answer
Is Parent/Guardian 1 mailing address the same as the Student? * if No, please complete the following sections *
Parent/Guardian 1 Mailing Address (Street or PO Box)
Your answer
Parent/Guardian 1 Mailing Address (City)
Your answer
Parent/Guardian 1 Mailing Address (State)
Your answer
Parent/Guardian 1 Mailing Address (Zip code)
Your answer
Parent/Guardian 2 FULL NAME
Your answer
Relationship to Student
Parent/Guardian 2 Home Phone (incl. area code) xxx-xxx-xxxx
Your answer
Parent/Guardian 2 Mobile Phone (incl. area code) xxx-xxx-xxxx
Your answer
Parent/Guardian 2 Work Phone (incl. area code) xxx-xxx-xxxx
Your answer
Parent/Guardian 2 Place Of Employment
Your answer
Is Parent/Guardian 2 mailing address the same as the Student? if No, please complete the following sections
Parent/Guardian 2 Mailing Address (Street or PO Box)
Your answer
Parent/Guardian 2 Mailing Address (City)
Your answer
Parent/Guardian 2 Mailing Address (State)
Your answer
Parent/Guardian 2 Mailing Address (Zip code)
Your answer
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