Application for Enrollment __________School Year

211 Maple Street, San Diego, CA  92103  ––619/236-8712, fax-619/236-8906

The Museum School offers a multi-age/developmental program for Kindergarten, 1st, 2nd, 3^rd, 4^th, 5^th, and 6^th grade students.  Student enrollment is based on space available via lottery, as per California law requires.  Any falsification of information on this application may result in the loss of enrollment.

Today's Date:                                                                 Entering Grade                       in Fall 200____

Student's Name:                                                                                                                                

Student's Birthdate and Year:                                                                                                            

Address:                                                                                                                                            

                                                                                                         Zip:                                           

Parent or Guardian Names:                                                                                                               

Email Addresses:                                                                                                                               

Home Phone(s):                                                                                                                                 

Cell Phone(s):                                                                                                                                    

Work Phone(s):                                                                                                                                  

Present School:                                                                       Present Grade Level:                        

(Please check)       Female:                                                          Male:                                              

The Museum School is a public charter school.  Student attendance is absolutely critical to our operation.  Please list any reasons why your child might not be able to attend school on a regular basis.