Enrollment

Legacy Charter School Lottery Form (one form submission per student)

Child’s First Name: *

Child's Last Name: *

Siblings Currently Enrolled at Legacy Charter: *

Birthdate: *

Age: *

Grade for 2011-2012 *

Kindergarten 1st 2nd 3rd 4th 5th 6th 7th 8th

Submission Date *

Gender *

Male Female

If your child is younger than school age, select the year he/she will enter Kindergarten (must be 5 years old by Sept. 1 of that year) *

2011 2012 2013 2014 2015 2016

Address *

City *

Mother's Cell/Work Phone: *

Home Phone *

State/Zip *

Mother's Name: *

Father's Cell/Work Phone: *

Parent Email *

Father's Name: *

Submit