Enrollment Request- Concordia Charter School

Request to Enroll

Welcome to Concordia Charter School! Please provide the following information and our Registrar will contact you to confirm class availability and complete the registration process.

This institution is an equal opportunities provider.

Question Title

* 1. Parent/Guardian Information:

Parent Name (first, last) *

Parent #2 Name (first, last) if applicable

Address *

Address 2

City/Town *

ZIP/Postal Code *

Email Address *

Phone Number *

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* 2. Please tell us about your child(ren). Child #1

Child's Full Name (first, last)

Child's Date of Birth (month/day/year)

Grade Entering in Fall 2021

Last school attended (if applicable)

Question Title

* 3. Child #2 (if applicable)

Child's Full Name (first, last)

Child's Date of Birth (month/day/year)

Grade Entering in Fall 2021

Last school attended (if applicable)

Question Title

* 4. Child #3 (if applicable)

Child's Full Name (first, last)

Child's Date of Birth (month/day/year)

Grade Entering in Fall 2021

Last school attended (if applicable)

Question Title

* 5. Child #4 (if applicable)

Child's Full Name (first, last)

Child's Date of Birth (month/day/year)

Grade Entering in Fall 2021

Last school attended (if applicable)

Question Title

* 6. Child #5 (if applicable)

Child's Full Name (first, last)

Child's Date of Birth (month/day/year)

Grade Entering in Fall 2021

Last school attended (if applicable)