Student Name *

Date of Birth *

Age *

Gender *

Ethnicity (race) *

Grade Applying for *

Mother's Name *

Mother's Address (Current Address, City, State Zip Code) *

Father's Name (Current Address, City, State Zip Code) *

Father's Address (Current Address, City, State Zip Code) *

School Currently Attending *

School Zoned to Attend *

Are sibling applying for CSI admission? *

Are brothers or sisters currently attending CSI? *

Please read the following statements and initial to the left of each: I request that my child be considered for enrollment at Carolina School for Inquiry. I understand that if there are more student applications than spots, selection of the students is by LOTTERY. I understand the program is rigorous and sets high expectations in the areas of academics and discipline. I understand this program requires parental involvement and I agree to be an active participant in my child’s education. *

I understand that I will have to pay $$ upon arrival *