Applicant Information

* indicates a required field

* Applicant's Name
Preferred Name		* Gender
* Date of Birth (mm/dd/yy)
* Application For Grade		* For Year
* Address 1
Address 2
* City State Zip
* Phone Number
* Have you had a child apply to Community School before?
If yes, please provide the name(s) and year(s) for each and click 'Add':

Parent/Guardian Information

* indicates a required field

Title		Title
* Name		Name
Preferred Name		Preferred Name
* Relationship to Applicant		Relationship to Applicant
Home Address		Home Address
City		City
State		State
Zip		Zip
Home Phone		Home Phone
Employer		Employer
Occupation		Occupation
Position/Title		Position/Title
Employer's Address		Employer's Address
Employer's City		Employer's City
Employer's State		Employer's State
Employer's Zip		Employer's Zip
Work Phone		Work Phone
Cell Phone		Cell Phone
* Email		Email
* Parents are	MarriedSingleSeparated Father has custodyMother has custodyJoint custody
* Applicant lives with
* Other children in applicant's family
If yes, please enter the details for each and click 'Add':
* Have other family members attended/graduated from Community School?
If yes, please enter the details for each and click 'Add':

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School Information

* indicates a required field

* Does the applicant attend school?	If yes, I have downloaded the Release of Records form and will mail it to Community School to complete the application process.
Applicant's Current School
School Address
School City
School State
School Zip
School Phone
Dates of Attendance
Reason for Leaving
* Has your child had any professional evaluations or interventions (psychological, neurological, auditory processing, language or speech)?
If yes, please give date and reason, and forward copies of evaluation and/or progress/update to the Admission Office.
* Are there any additional medical facts which will help us in meeting your child's needs (such as allergies, dietary needs, physical accommodations, or treatment for emotional concerns), as well as information regarding premature birth, adoption, divorce or family relocation?
If yes, please give details.

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Payment

* indicates a required field

There is a $90 non-refundable application/testing fee. Please enter your credit card information below.

Cardholder Information

* First Name
* Last Name
* Address
* City
* State
* Zip
Phone
* Email
* Email Confirmation

Credit Card Information

* Credit Card Type
* Credit Card Number
* Expiration Date	/
* Credit Card Security Code

We/I confirm that the information provided in this application is complete and accurate to the best of our/my knowledge. We/I understand that the withholding of information or incorrect information may disqualify the applicant for admission.

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Applicant Information

Parent/Guardian Information

School Information

Other Information

Payment

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Applicant Information

Parent/Guardian Information

School Information

Other Information

Payment

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