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Return To: Polaris Charter Academy Attn: Michelle Navarre 620 North Sawyer Chicago, IL 60624
Where Learning Has No Boundaries…
Application for Admission 2015/16 / Aplicacion Para Admisión 2015/16 Applications for the 2015/2016 school year are due by March 20 th, 2015. The PCA lottery will take place at Polaris on Wednesday, March 25th at 9:00 a.m.
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/ Información del Estudiante Student’s Legal Name/ Nombre del Estudiante: _________________________________________________________________________________________________________ First/ Nombre Middle/ Segundo nombre Last/ Apellido Birth Date/ Fecha de Nacimiento:
Female/ Mujer
Month/ Mes _________
Day/ Dia _________
Year/ Ano ________
Male/ Hombre
Current Grade Level/ Grado Actual ______________ Grade level for Aug. 2015/ Grado a cursar en agosto del 2015 ____________________ (K, 1, 2, 3, 4, 5, 6 , 7, 8)
(2) Family Information/ Informacion de la Familia: Sibling Information/ Información sobre los hermanos: Please provide the names of the applicant’s siblings, if any, who are also applying to Polaris Charter Academy. Please note a separate application must be completed for each child who is applying to Polaris Charter Academy 1. Sibling Name/ Nombres: _____________________________________________________________________________ Current Grade Level/ Grado Actual ______________ Grade level for Aug. 2015/ Grado a cursar en agosto del 2015 ___________________ (K, 1, 2, 3, 4, 5, 6, 7, 8) 2. Sibling Name/ Nombres: ______________________________________________________________________________ Current Grade Level/ Grado Actual ______________ Grade level for Aug. 2015/ Grado a cursar en agosto del 2015 __________________ (K, 1, 2, 3, 4, 5, 6, 7, 8)
(3) Parent Information/ Información de los Padres Relationship/Parentesco ________________________________________________________________________________ Full Name/ Nombre completo ____________________________________________________________________________ First/ Nombre Middle/ Segundo Nombr Last/ Apellido Home Address/ Dirección _______________________________________________________________________________ City/ Ciudad ________________________ State/ Estado _________ Zip Code/ Código ___________________________ Home phone/Teléfono ________________________Cell phone/ Celular _______________________________________ Email __________________________________________________________________________________________________
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Parent/Legal Guardian Signature/ Firma de Padres/Guardian
Date/ Fecha
PART B: Name of sibling who already attends Polaris Charter Academy ______________________________________________________________________________________________________ Current Grade Level ____________________
Current Room Number ______________________________
