Prospect Form 2019

Linwood Public Charter School is currently enrolling students in Grades Pre K-8th for the 2019-20 school year. LPCS helps develop and strengthen ethical, moral, and civic values— equipping students with the knowledge, skills, and social judgment to help them face the challenges of the future. LPCS provides equal access to a tuition-free, public education for all students, regardless of “intellectual or athletic ability, measures of achievement or aptitude and status as a handicapped person.”

Name *

First

Middle

Last

Date of Birth *

Age *

Gender *

Grade to Enter *

Home Address *

City *

State *

Zip Code *

Present School *

Present Grade *

Social Security Number *

Does your student have an IEP/504 Plan? *

What school district does the student reside in? *

Has the student ever been expelled? *

If yes, please explain.

Parent/Guardian *

Full Name

Relationship to Student *

Home Address

If different from student.

Phone Number *

Email *

Parent/Guardian Signature *

Today's Date *

How did you learn about our school?

Name

You will need to provide with this completed form your child’s: Birth Certificate, Social Security Card, Immunization Record, and his/her last Report Card.

Prospect Form 2019

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