Lottery Enrollment Form

20202021 School Year

Please provide the following information:

Parent Information  
Parent/Guardian first name
Parent/Guardian last name
Street Address
Address (cont.)
City
State
Zip
Work Phone
Home Phone
   
Parent/Guardian first name
Parent/Guardian last name
Street Address
Address (cont.)
City
State
Zip
Work Phone
Home Phone
Student Information
Student #1  
First Name
Last Name
Gender
Date of Birth
Grade for 20202021 school year
Current School
   
Student #2  
First Name
Last Name
Gender
Date of Birth
Grade for 20202021 school year
Current School
   
Student #3  
First Name
Last Name
Gender
Date of Birth
Grade for 20202021 school year
Current School

     

 

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