Truebright Academy Charter School Student Application

TRUEBRIGHT SCIENCE ACADEMY STUDENT APPLICATION REQUEST FORM

Dear parents and applicant,

Thank you for your interest in Truebright Science Academy Charter School. Please fill out this form completely, and we will send you a full application form.

Student's Contact Information:

Name :

First:

Middle:

Last:

Email:

Phone Number:

Home Address :

Street:

Apt #:

City:

County:

State:

Zip:

Date of Birth (mm/dd/yy)

Gender:

Male Female

Primary Language:

English Spanish Other, please specify:

School Information:

Current School Name:

Current School Address:

Street:

City:

State:

Zip:

Type of School:

Public School Private School Registered Home School
Charter School Not in School / Other

Grade Applying For:

Only grades 7 to 10 will be admitted in the 08-09 school year.

Application for:

2008-2009

Parent / Custodial Parent / Guardian Information:

Relation to Applicant:

Name(s):

Email:

Cell Phone Number:

Other:

Comments:

How did you hear about us?:

Mail Brochure Friend Other, please specify:

Thank you for your time!