Capital City Public Charter School: Application

Application for the 2010 - 2011 School Year

Student Information First NameRequired Last Name:Required Middle Name: Gender: Current Grade:Required Grade 2010/2011 School Year:Required Date of Birth:Required Address 1:Required Address 2: City:Required State:Required Zip:Required Race (optional) : Current School:Required Does your student participate in National School Lunch?

Parent/Guardian 1 Details Who has legal custody of this child? First Name:Required Last Name:Required Home:Required Work: Cell: Email: Best way to contact?

Parent/Guardian 2 Details First Name: Last Name: Address 1: Address 2: City: State: Zip: Home: Work: Cell: Best way to contact?

Additional Info Do any siblings currently attend Capital City?
Are there any siblings applying to Capital City?
How did you hear about Capital City?

Thank you for your interest in Capital City Public Charter School!

The deadline for applications for this lottery is March 15, 2010. All duplicate applications will be discarded.