eStem Public Charter Schools » Student Application for Middle School

Middle School Application

Please enter the text seen in the box below
Student First Name(required)
Student Last Name(required)
Student Middle Name(required)
Student AddressStudent Address(required)
City/State/Zip(required)
Home Phone(required)
Email Address(valid email required)
Student Birth Date(required)
Child's Age (please select one)(required)
Gender
Male Female
Ethnic Background (please select one)(required)
Last School Attended(required)
Current Grade(required)
Parent/Legal Guardian Name(required)
Address if different from student
By submitting this form, I understand that this application is only preliminary and does not guarantee a position for my child at the eStem Public Charter Schools. I attest that I am the legal guardian for this child and if my child is able to attend eStem Public Charter Schools, I will participate in the school’s plan for academic expectations and parent involvement. I agree to allow eStem Public Charter Schools to receive my child’s student records from the sending school district.
I agree to the terms listed above
Please notify me that the form was succesfully completed.

Student Application for Middle School