Desert Sky Community School - Enrollment Form School Year 2010-2011

School Site Address: 122 N. Craycroft Rd. #3, Tucson, AZ 85711 Phone: (520) 745-3888

Student Name: Date of Birth (mm/dd/yyyy) :

First:_______________________Middle:________________Last:_____________________________

Please check one: Enrolling new student _____ Re-enrolling current student _____

Enrolling sibling – current student’s name;______________________________________

Anticipated grade level in August 2010 (circle one): K 1 2 3 4 5

Age at enrollment policy: Children must be 5 yrs old by September 1st to enroll in Kindergarten. Children must be 6 yrs old by September 1st to enroll in First Grade.

Last School of Attendance in 2009-2010:

School Name: _________________________________ City : _______________ State : _______

Special Education Category (if applicable):____________________________________

English Language Learner (primary language is not English): yes no. If yes, primary language is:

Parent/Guardian Information:

First Name:___________________ Middle :___________ Last:_____________________________

Street:______________________________________________Apartment/Suite:_______________

City:__________________________ State:_________ Zip Code:__________________________

Phone Number: (____)___________________ Other Number: (____)_______________________

Email address: _______________________________ Where did you learn about our school?

Friend DSCS Parent Previous School Website Radio Newspaper Flyer Other:______________

Parent/Guardian participation (To be completed by school office)

[ ] Informational Meeting Date: _________ [ ] Appointment with Administrator Date: __________

Form is invalid without signature

Parent/Guardian(s) Signature:

_________________________________________

Received by: