Catalyst Academy Charter School Application

Student Application Form

Fill out the form below to apply for the 2020-21 school year at Catalyst Academy Charter School.
By completing the Student Application Form, you are entered into the Catalyst Academy Charter School Lottery. If you are selected through the randomized lottery, you will then be offered the opportunity to enroll your child as one of our Founding Scholars for the 2020-21 school year. If you are not selected through the random lottery, you will be automatically placed on the waitlist.
Student Name*

First NameMiddle NameLast Name
Select which grade the student is applying for in 2020-21? (i.e. the grade they will be entering in August 2020)*

Kindergarten1st Grade
Kindergarten students must be 5 years old on or before September 30th, 2020 to be eligible for enrollment.

Proof of child's age must be verified (birth certificate, immunization record, passport) once a spot is offered and a child is enrolling.
Student Birth Date*

MonthDayYear
Student Gender*
Student Residence/Address*

Street Address

Street Address Line 2

CityState

Zip Code
Parent/Guardian Name*

First NameLast Name
Parent/Guardian E-mail*

Confirmation Email
Parent/Guardian Mobile Number*

Area CodePhone Number
Parent/Guardian Other Phone Number

Area CodePhone Number
What is the student's current school?*
Does this student have a sibling that is also applying to Catalyst Academy Charter School?*

YesNo
^A sibling is defined as one of two or more individuals having at least one common parent/guardian.
Sibling Name

First NameMiddle NameLast Name

Free or Reduced Lunch

Catalyst Academy's lottery policy provides increased opportunities for applicants who reside in the Pittsburgh Public Schools and who meet the eligibility guidelines for the National School Lunch Program. These applicants will receive an extra weight in our lottery.

1. Who can get FREE OR REDUCED PRICE meals?
- All children in households receiving Supplemental Nutrition Assistance Program (SNAP) (formerly the Food Stamp Program) or Temporary Assistance for Needy Families (TANF) benefits are eligible for free meals.
- Foster children who are under the legal responsibility of a foster care agency or court are eligible for free meals.
- Children participating in their school’s Head Start program are eligible for free meals.
- Children who meet the definition of homeless, runaway, or migrant are eligible for free meals.
- Children may receive free or reduced price meals if your household’s income is within the limits on the Federal Income Eligibility Guidelines. Your children may qualify for free or reduced price meals if your household income falls at or below the limits on this chart.
FEDERAL ELIGIBILITY INCOME CHART For School Year 2019-2020
Does the student qualify for free or reduced price lunch?*

YesNo
I certify (promise) that my response is accurate to the best of my knowledge. I understand that school officials may confirm the accuracy of this statement upon any subsequent submission of a Household Application for Free and Reduced Price School Meals. I am aware that if I give inaccurate information, my children may lose their enrollment preference and, if enrolled, may be removed from the Charter School’s rolls.
Please enter your initials to certify your eligibility for Free or Reduced Lunch Status*
Initials
Parent/Guardian Certification of Free or Reduced Lunch Status

Clear

As a charter school authorized by the Pittsburgh Public Schools (PPS), residents of the City of Pittsburgh/Pittsburgh Public Schools receive a preference in the Catalyst Academy Charter School lottery.
Are you a resident of the City of Pittsburgh (Pittsburgh Public Schools)?

YesNo
Residency within the Pittsburgh Public Schools must be verified^ once a spot is offered and a student is enrolling. Failure to provide proof of residency may result in a loss of an enrollment spot.

^Proof of residency can come from utility bills, or official public assistance documents. Proof of residency must contain your name and address.
I certify (promise) that my response is accurate to the best of my knowledge and reflects my child's residency in the Pittsburgh Public Schools/City of Pittsburgh.

I understand that school officials will confirm my child's residency upon offering enrollment.

I am aware that if I give inaccurate information, my children may lose their enrollment preference and may be removed from the Charter School’s rolls.
Please enter your initials to certify your child's residency in the Pittsburgh Public Schools / City of Pittsburgh*
Initials
Parent/Guardian Certification of City of Pittsburgh/Pittsburgh Public Schools Residency

Clear
If not Pittsburgh Public Schools, what school district do you reside in?

WilkinsburgWoodland HillsPenn HillsOther
If you were referred to Catalyst Academy Charter School by a friend, please enter their name here so they are eligible to receive a free school uniform item.

Student Application Form