Online Enrollment Form

 

I am enrolling my child at:
Mission Charter School (K-8) Mission Academy High School

Student First Name:*

Student Last Name:*

Full Legal Name:*

Nickname(s):

Date of Birth:*       Primary Language Spoken at Home: *

 Age:*  Gender* Select One Male Female   Ethnicity* Select One African-American Asian Hispanic Native American Caucasian Other

Residence

Street Address*	Student's Cell Number
Apt No.	Student's e-Mail: Address*
City, State, Zip code*	Guardian Email Address*
Parents/Guardians
Legal Mother*	Legal Father*
Day Phone*	Day Phone*
Evening Number*	Evening Number*
Cell Number	Cell Number
If the student does not live with legal parents please complete the following:
Female Parent/Guardian's Information	Male Parent/Guardian's Information
Legal Female Guardian	Legal Male Guardian
Day Phone	Day Phone
Evening Number	Evening Number
Cell Number	Cell Number
Scholastic Information
Grade* Select Grade Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade 7th Grade 8th Grade 9th Grade 10th Grade 11th Grade 12th Grade	Last Grade Attended* Select Grade Pre-School/None Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade 7th Grade 8th Grade 9th Grade 10th Grade 11th Grade
Additional Comments	Previous School School District* Street City, State, Zip code
Medical Concerns
Please use the area below to identify for us any medical concerns that might be important for us to know. Please specify how you wish us to address those medical problems should they arise in the course of the school day.
Special Education/Special Needs
Please use the area below to identify for us any Special Education or Special Needs that we should address during your child's learning process. It is important to us that such needs are addressed in a sensitive and caring manner so as to improve your child's educational experience.
e-Mail Address of person submitting enrollment form:*

 

    

 

Instructions

Please provide the following information. (Those boxes marked with a "*" are required fields)

 

We know your time is valuable and we want to make this paperwork process as painless as possible.  For that reason we are accepting your data on-line. 

First of all, remember that your privacy is strictly honored by all of our staff as we accept, evaluate, and plan learning environments that meet your child's unique needs.  That privacy is further protected in the U.S. Code, Family Educational Rights and Privacy Act (FERPA) This document is also available as a download from our site. Click here to download it.

Our on-line registration process is designed to give you the most flexible way of meeting the requirements we have for educational and family data on every child we enroll.

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Download Form

If this approach is more than you care to attempt, then download the form to you computer.  Off-line, you can fill it out, print it out, or even still submit it as an email.

Click here to download

When all else fails, give us a call and we can guide through the realms of cyberspace that make all this happen.

(602) 944-2097

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Send us an e-mail

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