HRACS TK-12 Request for Enrollment
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Please fill out the request for enrollment questions below.  We will contact you regarding the next steps soon! Thank you for your interest!
Parent First Name *
Please list the parent or legal guardian first name
Parent Last Name *
Please list the parent or legal guardian last name
Parent Email Address *
Parent Phone Number *
Please use format:  xxx-xxx-xxxx
Street Address *
City *
Zip Code *
County of Residence *
Today's Date *
Date
Requesting Enrollment For *
Please select the year you are requesting to enroll at Hart-Ransom Academic Charter School:
Required
Number of Students to Enroll *
Select the number of students you would like to enroll
Program of Interest *
Please select the program/s you wish to use for your students
Required
Student Information
Please list the FIRST and LAST name, current GRADE level and BIRTHDATE for each student you wish to enroll.
Click return after each student is added to create a separate line. Add Grade Level - for year applying followed by birthdate of student.  Please see guidance on website regarding Kindergarten and Transitional Kindergarten age guidelines.
EXAMPLE:
John Smith - 5th grade - 3/07/07 (*click return/enter)
Jane Smith - 2nd grade - 4/08/10
Student Information *
Please list each student's name and his/her current school of enrollment.
Click return after each student is added. (SEE EXAMPLE BELOW)
John Smith - Little Red Schoolhouse (*click enter/return)
Jane Smith - Little Red Schoolhouse
JIm Smith - Not in School yet
Current School *
Are the student/s in good standing with their present school (behavior, academic, attendance, etc)?
Please explain situation below for any student who is NOT in good standing.
Be sure to include entire name of student in explanation
Good standing? *
If no, explain situation
If not in good standing, please explain situation (include name, date, and situation)
Special Needs & Assessments
Does any child have a 504 Plan? *
Do any of the children listed above have a 504 Plan in place
If yes, please explain 504 Plan
NOTE: Parent will need to provide a complete copy to school prior to enrollment if answering yes to 504 Plan
Special Education/IEP *
Have any child/ren listed above ever been tested / enrolled in special education?
If yes, select type of IEP
Parent will need to provide a complete copy to school prior to enrollment if answering yes to IEP
If yes, describe IEP
Please list the student name and explain the IEP situation for any child listed above  ***A copy of IEP must be submitted with pre-enrollment (you may fax, email, hand delivered to school)
Has your student ever been referred to the School Attendance Review Board? *
Homeschool Instruction Environment
Homeschool experience *
Required
Homeschool experience explained
Choosing to homeschool *
Please describe the reasons you would like to homeschool with Hart-Ransom Academic Charter
Standardized Assessments
Each year, Hart-Ransom Academic Charter School administers assessments.  It is our expectation that all students participate.
Standardized testing participation *
My child will participate in standardized testing
If no, explain assessment situation
Please explain why your student could not participate in assessments.  Is there anything that would prevent your child/ren from participating in these assessments?
One last question...
How did you hear about us? *
Referred by:
If you have a friend, family member, or know a staff member at HRACS please list their name below
Please note: this is NOT a guarantee of enrollment.  Someone will be contacting you soon!
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This form was created inside of Hart-Ransom Academic Charter School.