Application for Admission

Application for Admission

2022-2023 School Year
- If your family is new to Polaris Charter Academy, only complete Part A of this application.
- If you have one or more children already attending Polaris Charter Academy, complete Parts A and B of this application.
Part A:
(1) Student Information:
Student’s Legal Name *

First Name Middle Name Last Name
Birth Date *

Month Day Year
Date
Gender *

Female Male
Current Grade Level *
Grade level for Aug. 2022 *
(2) Family Information:
Sibling Information:

Please provide the names of the applicant’s siblings, if any, who are also applying to Polaris Charter Academy.
Sibling #1 Name

First Name Middle Name Last Name
Sibling #1 Current Grade Level
Sibling #1 Grade level for Aug. 2022
Sibling #2 Name

First / Nombre Middle Name Last Name
Sibling #2 Current Grade Level
Sibling #2 Grade level for Aug. 2022
Sibling #3 Name

First / Nombre Middle Name Last Name
Sibling #3 Current Grade Level
Sibling #3 Grade level for Aug. 2022
(3) Parent Information:
Relationship *
Full Name *

First Name Middle Name Last Name
Home Address *

Street Address

Street Address Line 2

City State

Zip Code
Home phone

Area Code Phone Number
Cell phone

Area Code Phone Number
Email *
example@example.com
Part B
If you have one or more children already attending Polaris Charter Academy, complete Part B of this application.
Name of sibling who already attends Polaris Charter Academy
Current Grade Level
How did you hear about us?

Facebook Twitter Instagram Google Community Event From a current student/family
If you heard about us from a current student/family, please name them here:
Should be Empty:

Application for Admission

Part A:

Part B