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Academics Early Childhood University (ECU) Enrollment. . . Information Procedures Student Activities Why Choose US?

University Schools Application

Instructions: The form is printable and can be filled out either online or by hand. To fill out by hand, click the "Submit" button and Print. Otherwise, fill in the blanks, click "Submit" and Print.

***The form must be handed in signed by the legal guardian and contain all of the following information.***

PARENT RESPONSIBILITY : Enrollment is based on a lottery draw. It is the applicant's responsibility to notify the school of any address change so that we can contact you in the event of an opening.

Current Grade:

This student is requesting admission to the Grade for the school year

Sibling currently attending University Schools K-12 program: Yes No
If yes, name of sibling(s):
PARENT RESPONSIBILITY: Once you have a child enrolled in University Schools, it is a parent's responsibility to notify the school office if the child has other siblings in the lottery pool that need to be marked as "sibling."

Last Name:

First Name:

Middle Name:

Date of Birth:

Gender:

Current Age:

Student lives with: Father Mother Father and Mother
Other

Mother's Name:	Street Address:
Mother's Home Phone:	Address (Cont.)
Mother's Work Phone:	City:
	State (Two letter Abbreviation):	ZIP Code (Five Char. Version):

Father's Name:	Street Address: "same" if same as mother's
Father's Home Phone:	Address (Cont.)
Father's Work Phone:	City:
	State (Two letter Abbreviation):	ZIP Code (Five Char. Version):

Last School Attended:

School Address:

If there is not space at University Schools for your child, what school will he/she attend?

Has this student ever been suspended or expelled from a previous school?

No Yes

If yes, please explain:

Due to reports we must provide to the state regarding our enrollment, we request the following information:

Ethnicity:
American Indian/Alaskan Native
Asian/Pacific Islander
Black (Not Hispanic)
Hispanic
White (Not Hispanic)
Other

I hereby agree to the statements on the "Enrollment Information" page and understand the sections marked PARENT RESPONSIBILITY.