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CHARTER
CONSERVATORY
for
Liberal Arts & Technology
Application
for Admission
(last)
(first)
(middle)
Age Sex
Date of Birth / /
Social
Security #
_______________ With
whom does student live?
Address
E-Mail__________________________________ Business
Address
Telephone______________
Address
E-Mail____________________
Business Address Telephone_______________ Other ( specify relationship) _________________________________ Name
Home Phone_______________ Cell
____________ Address
E-Mail____________________
Business Address Telephone_______________ Name of present school Principal________________ Address Telephone__________________ Any Special
Records?(discipline,
special education, attendance, etc.)
Date of
application
______________________________________________________________ Signature of
parent or guardian
NOTICE OF
NONDISCRIMINATORY
POLICY |