6th-8th grade Pre-Application Form

STUDENT MUST BE OF APPROPRIATE AGE FOR DESIGNATED GRADE LEVEL BY SEPT. 15, 2026

Grade Applying For:

Student's Name

Date of Birth

Date

Gender

Ethnicity

Race

Other

English Proficiency:

Other

Does your child have an IEP (Individual Educational Plan) or 504 Plan?

(Disclosure Statement: This information is being sought for program planning purposes related to staffing and budgeting, not to determine the student's enrollment status.)

Are you concerned about your child's behavior, speech, emotional or academic?

If yes, please specify:

Current School:

Current grade level:

Child resides with:

1st Parent/Guardian's Name:

(Adult who is completing this application)

Primary Language:

Address:

Address

Street Address Line 2

Postal / Zip Code

Phone Numbers:

Please enter a valid phone number.Format: (000) 000-0000.

Alternate Phone Number

Email address

example@example.com

Best time to contact you:

2nd Parent/Guardian's Full Name

Primary Language

Address:

Address

Street Address Line 2

Postal / Zip Code

Phone Numbers: Home/Cellular

Format: (000) 000-0000.

Alternate

Email address

example@example.com

Best time to contact you:

Family Unit Size

(Example: 2 children + parent= 3)

Are there sibling(s) who(se) currently attend UCC schools?

If yes, please list each child:

First Name Last Name Grade

Are you applying for other children this academic school year?

If yes, please list each child:

First Name Last Name Grade

Which UCC Center are you interested in?

How did you hear about UCC schools?

NOTE: Completing this application does not guarantee your child’s enrollment at UCC Middle Schools. Placement is based on availability and eligibility requirements. Families selected to move forward in the enrollment process will be contacted to schedule an appointment. Required enrollment documents must be provided at that time. If accepted, students and families are expected to follow all school policies, including attendance requirements, dress code guidelines, and parent engagement expectations.

Parent/Guardian Signature

Date

6th-8th grade Pre-Application Form | 2026-27 School Year

Student's Information

Parent/Guardian Information

Family Information

Which UCC Center are you interested in?