MOSAICS Public School Application for 2020-21
By completing this application, you are entering your child into the pool of applicants for the 2020-21 school year. Completing this application does not guarantee your child a spot at MOSAICS Public School. There are 60 seats per grade level in grades K-4 available. Should there be more applications than seats available, a lottery will occur on March 14, 2020. Applications submitted before March 7, 2020 will be entered into the lottery. Applications submitted after March 7, 2020 will be placed on the wait list in the order received. Families will be notified within 7 days of the March 14 lottery if their children were selected for enrollment or placed on the wait list. When filling out your application, please note that kindergartners must be age 5 on or before Sept 1, 2020 and first graders must be 6 on or before Sept 1, 2020. Proof of family relationship may be required for verification. Upon acceptance into MOSAICS Public School, a birth certificate, proof of residence, 504, IEP, and immunization records may be requested for verification.

For more information about the lottery process, please visit www.mosaicsps.org/faqs.

All prospective students will be given the opportunity to enroll regardless of race, color, national or ethnic origin, religion, gender or social or economic status or special needs.


Email address *
Parent/Legal Guardian First and Last Name *
Your answer
Additional Parent/Legal Guardian First and Last Name
Your answer
Home Address (Street, City, Zip Code) *
Your answer
Mailing Address --if different than home (Street, City, Zip Code) *
Your answer
Phone Number (with Area Code) *
Your answer
Additional Phone Number (with Area Code)
Your answer
Additional E-mail Addresses (Please enter all the email addresses that you check frequently. Separate emails by comma.)
Your answer
What is your child's first name? *
Your answer
What is your child's last name? *
Your answer
What is your child's date of birth? *
MM
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DD
/
YYYY
Which grade will he or she be enrolling into in 2020-21? *
Name of last school attended *
Your answer
Before submitting this application, the parent or legal guardian of the children understand the following: I understand that any false or incorrect information on this application could jeopardize my child's enrollment should he/she be selected to attend MOSAICS Public School. I am authorized to sign as parent/legal guardian of the child(ren) on this application and the child(ren) on this application resides with me at least 50% of the time. Please sign electronically below. *
Your answer
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