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Cailloux/Najim Admissions Application

School Year: 2020-2021

Big Springs Charter System

Please complete the form below. Required fields marked with an asterisk *

STUDENT INFORMATION

First Name*

Answer Required

Middle Name

Answer Required

Last Name*

Answer Required

Date of Birth*

Answer Required

Age*

Number Required

Grade Level*

Number Required

Previous School*

Number Required

PARENT/GUARDIAN INFORMATION

First Name*

Answer Required

Middle Name

Answer Required

Last Name*

Answer Required

Address*

Answer Required

City*

Answer Required

Zip/Postal*

Answer Required

Home Phone*

Number Required

Mobile Phone

Number Required

Work Phone

Number Required

Email 1

Answer Required

Proof of residency in the form of an official governmental document is required before actual registration and enrollment ofyour child at Big Springs Charter School.

The above information is required for a permanent school record of your child and will be used by school personnel. Presenting false information is a violation of state law.

I certify that the information given above is correct. *

Answer Required

Yes

Parent/Guardian Signature:*

Answer Required

Date:*

Answer Required