Polaris Admissions Application

Student Information
Student Name*

First NameMiddle NameLast Name
Date of Birth*

MonthDayYear
Date
Gender*
What Grade Are You Applying For?
Does this child have a sibling who is also applying to Polaris Charter Academy?

Yes

Parent/Guardian Information
Parent/Guardian Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Were you referred by one of our current families?
Signature

Clear
Polaris Charter Acaademy does not discriminate on the basis of sex, national origin, ethnicity, religion, disability, or academic or athletic ability.
Should be Empty:

Polaris Charter Academy