Rcvd ____________
Tour __________
Approved 
Denied 
Accepted 
Declined 
Village Charter School
Application for Enrollment
•
We recommend that all interested families view our website www.villagecharterschool.net
•
Completion of this application does not guarantee placement.
•
•
Kindergarten: If VCS has more approved applicants than space, names of all kindergarten students approved
for enrollment will be placed into a lottery drawing.
•
1st – 8th: If VCS has more approved applicants than space, names of all approved students will be placed on a
waiting list in order of receipt of this application.
The waiting list will remain active through the applied school year.
Student Name: ________________________________________
School year applying for: __________
Applying with sibling  Yes  No
Grade applying for: _______________
Sibling of VCS student  Yes  No
Parent Name: ________________________________________
Phone: _______________________________
Parent Name: ________________________________________
Phone: _______________________________
Briefly describe your child:
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
Briefly state why you would like your child to attend Village Charter School:
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
Please explain any behavioral issues that your child has:
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
Enrollment> New.Student.Enrollment.Application
(Page 1 of 2) Rev 5/6/15
Village Charter School - New Student Application for Enrollment
________________________________
Pupil’s Legal Last Name
_____________________________
Pupil’s First Name
__________________________________________
Residence Street Address: (No PO Box)
_________________________
Home Phone
__________________________
City
Full Name of Parent/Guardian
__________________
Zip
_____________
Grade (applying for)
_______________
Birth Date
_______________________________
Birth Place (City)
Cell Phone
E-mail Address
□ Mother
□Step Mother
□Guardian
□ Father
□Step Father
□Guardian
□ Mother
□Step Mother
□Guardian
□ Father
□Step Father
□Guardian
Male 
Female
___________________
Birth Place (State)
Living With
□ Yes □ No
□ Yes □ No
□ Yes □ No
□ Yes □ No
School History
Name of current/last school attended:
Phone:
Fax:
Address:
Last date attended:
Date of first school entry:
Expulsion Information:
Has the student ever been expelled from school?
□ Yes □ No
If yes, please provide the date of expulsion:
If yes, please provide reason for expulsion:
Requested with application:
1) Copy of birth certificate
All information provided on this application is confidential.
Signature of Parent/Guardian: ____________________________________________
Date: ______________________
(Page 2 of 2) Rev 5/6/15