PEACE Student Application (Paper Version)

Student Enrollment Application

Paper Version
SCHOLAR GENERAL INFORMATION
First Name*
Middle Name
Last Name*
Gender (Optional)
Date of Birth*

MonthDayYear
Date
For Kindergarten entry, your scholar's 5th birthday should be before September 1, 2018.
Grade of Entry (Fall 2023)*

Kindergarden1st2nd3rd
PARENT/GUARDIAN GENERAL INFORMATION
Name*

First NameLast Name
Primary Phone #*
This number is my...*

CellHomeWork
Secondary Phone #
This number is my...

CellHomeWork
Do we have permission to send you updates via text/email?*

YesNo
Email*
example@example.com
Relation to Scholar*
SCHOLAR ADDRESS
Street Address*
Apartment, unit, suite
City*
State*
Zip/Postal Code*
Home Language*

EnglishSpanishOther
Home District*
Home School
SIBLINGS
Siblings Does the scholar have a brother or sister eligible to attend PEACE (in K-3 in Fall 2023)?*

YesNo
Sibling's Name
Sibling's Grade for Aug 2023
Sibling's Date of Birth (write 0 if no sibling)*
Does the scholar and this sibling live together at the same address?

YesNo
Student Enrollment Application

Paper Version
EMERGENCY CONTACT GENERAL INFORMATION
Name

First NameLast Name
Primary Phone #
This number is their...

CellHomeWork
Secondary Phone #
This number is their...

CellHomeWork
Do we have permission to send them updates via text/email?

YesNo
Email
example@example.com
Relation to Scholar
ADDITIONAL INFORMATION
Does either parent/guardian serve on the board of this organization?*

YesNo
Name

First NameLast Name
Does either parent/guardian work on staff for this organization?*

YesNo
Name

First NameLast Name
Where did you learn about the PEACE Student Enrollment Application:*

PEACE Board MemberPEACE Staff MemberPEACE EventSocial MediaOther
Board Member Name
Staff Member Name
PEACE Event Name
PEACE Event Date

MonthDayYear
Date
Social Media Platform
Other Name
Please email your completed application to PEACE@PEACEAcademyCharter.org.
Should be Empty:

Student Enrollment Application

SCHOLAR GENERAL INFORMATION

PARENT/GUARDIAN GENERAL INFORMATION

SCHOLAR ADDRESS

SIBLINGS

Student Enrollment Application

EMERGENCY CONTACT GENERAL INFORMATION

ADDITIONAL INFORMATION