Impact Public Schools - Enrollment form
*If you have any questions about this application, please call Natalie Hester at (206)356-7078*
Email address *
Student's Last Name
Your answer
Student's First Name
Your answer
Grade level (2018 - 2019)
Gender
Student's date of birth
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Student's street address
Your answer
City
Your answer
State
Your answer
Zip code
Your answer
Does your child receive free and reduced lunch?
Is your child Hispanic or Latino origin?
What is your child's race?
Parent/Guardian #1: First Name
Your answer
Parent/Guardian #1: Last Name
Your answer
Parent/Guardian #1: Phone Number
Your answer
Parent/Guardian #1: Primary Spoken Language
Does the child live with this parent/guardian?
Parent/Guardian #2: First Name
Your answer
Parent/Guardian #2: Last Name
Your answer
Parent/Guardian #2: Phone number
Your answer
Parent/Guardian #2: Primary Spoken Language
Does the child live with this parent/guardian?
Do you have another child that has applied to Impact Public Schools?
How many?
Sibling's First Name
Your answer
Sibling's Last Name
Your answer
Siblings Grade (2018 -2019)
How did you hear about Impact Public Schools?
Tell us more about how you heard about us? (e.g., Who told you? Which event did you attend?)
Your answer
By typing my name in the box below, I acknowledge that all information provided is correct. The open enrollment period is July 13, 2017 to January 8, 2018. In addition, I understand that admission to Impact Public Schools is on a space-available basis. If more applications than openings are available, Impact Public Schools will hold a random, public lottery. The lottery is scheduled for January 9, 2018 at 5pm at SeaTac City Hall: 4800 S 188th St SeaTac, WA 98188. All families will be notified via mail of their admission or waitlist to Impact Public Schools following the lottery.
Your answer
Date
MM
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DD
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YYYY
Thank you for applying to Impact Public Schools for the 2018 - 2019 school year!
A copy of your responses will be emailed to the address you provided.
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