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Application

STUDENT INFORMATION

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Date of birth (*)
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Current School Name & Address, if any:
Current grade:
New York City Public School ID number:
Grade Student will enter in August 2012:
Note: Student must be 5 years old by December 31, 2012 to be eligible for Kindergarten - 2nd grade.

PARENT/GUARDIAN INFORMATION

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SECOND PARENT/GUARDIAN INFORMATION

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Brothers and sisters have preference in the admissions lottery, but only if an application is submitted for each one.

Name of sibling:
Grade:
Name of sibling:
Grade:
This application will not be valid if it contains incorrect information. This is an equal opportunity, free public charter school, open to all children. Applications are good for one year. For information, please call: 718-599-2176. Admission is open to all students residing in the State of New York, but preference is given to students residing in School District 14. Proof of residency is required. Applications must be postmarked no later than April 2, 2012.
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