PCMS Lottery Enrollment/Waiting List Application
Please complete this application for the lottery/wait list. If the student enrolling has ever had a sibling or attended PCMS in the past, please indicate below. PLEASE CONTACT THE SCHOOL at (530) 872-7277  or jrobbins@pcms.tv TO ENSURE WE HAVE RECEIVED YOUR APPLICATION.  Applications received AFTER March 14, 2022 will be added to the student wait list for 2022-2023 school year. This application is not a guaranteed placement for your student with PCMS.
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Student's LAST Name *
Student's FIRST Name *
Student's Grade in the 2022-2023 School Year *
New Family or Sibling of PCMS Alumni *
Name of Student's Current (2021-22) School  Now Attending *
Student's Current School Address, City, and State *
Student's Date of Birth *
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Student's Gender *
Please indicate whether your child qualifies for free or reduced lunch. *
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Phone Number *
Please add the BEST number at which we can reach you.
Parent/Guardian's Email *
Contact Name (Parent / Guardian) *
Mailing Address *
Mailing City *
Mailing Zip Code *
I certify that I have reviewed this document and to the best of my knowledge, the information contained herein is true and complete. By selecting I AGREE below, I declare under penalty of perjury that I am the parent or legal guardian of the above-named student. *
By choosing "I AGREE" and entering your name in the boxes below, you are effectively providing your signature, indicating that all the information on this form is true and accurate, to the best of your knowledge.
FULL NAME (Digital Signature) *
Entering your name in the boxes below, you are effectively providing your signature, indicating that all the information on this form is true and accurate, to the best of your knowledge.
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