LISA-Chenal ONLINE APPLICATION FORM 2018-2019

Dear Parent/Guardian of Kindergarten and First grade applicants,
By the Department of Education rules and regulations,
1) Kindergarten: Student has to be 5 years-old by August 1, 2018 (students who are born between August 1, 2012 to July 31, 2013 are eligible to apply)
2) First Grader: Student has to be 6 years old by August 1, 2018 (students who are born between August 1, 2011 to July 31, 2012 are eligible to apply)
If a student is younger than stated age above, the registration will be denied.
For further information you may check Department of Education's website(click here).


Student Information:

First Name
Middle Name
Last Name
Date of Birth
Ethnicity/Race Ethnicity: Hispanic / Latino
Race: White
Race: African American
Race: Asian
Race: Native American
Race: Pacific Islander / Hawaiian
Address
Zip Code
Home Phone#
Other Phone#  Describe
Grade Applied For
Current School
Does the applicant have a sibling who's attending this school or other LISA ACADEMY campuses?
Does the student have any documented history of a criminal offense or juvenile court adjudication?
If yes, please explain:

Parent/Guardian Information:

First Name
Last Name
Email

We/I, the undersigned, hereby certify that, to the best of our/my knowledge and belief, the answers to the foregoing questions and statements made by us/me in this application are complete and accurate. We/I understand that any false information, omissions, or misrepresentations of facts may result in rejection of this application or future dismissal of the applicant.


NON-DISCRIMINATION STATEMENT: It is the policy of LISA Academy-Chenal to comply with all state and federal regulations regarding admission and not to discriminate during the admission and the lottery process on the basis of gender, national origin, ethnicity, religion, disability, academic, artistic, athletic ability, or the district the child would otherwise attend.