Charter School Name:
*
Charter School Address
City:
Zip code:
School Authorized By:
Charter School Site Leader (Principal, Director or Lead Teacher)
School Phone:
School Website:
Grade Levels:
Number of Students
Year School Opened
Focus of the School
Names of Two Voting Representatives
Identify the names of two designated representatives of your charter school who will receive WCSA communications and be entitled to vote for WCSA directors.
First Representative Name:
Title:
Address:
Day Phone:
Email:
..................................................................................................
Second Representative Name:
Title:
Address:
Day Phone:
Email:
Submit
Should be Empty:
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