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STUDENT ADDRESS:

Apt# Zipcode

Date of Birth

Parent/Guardian Information

Who has the authority to apply for this child to attent Green Tech High Carter School?




ADDRESS:

Apt# Zipcode

Email

Special Needs Information (voluntary, not required)

Has this student ever been evaluated to determine a need for any type of special education services? (Responding to this question is voluntary and will not affect admissions in any way.)

YES, this student has been evaluated. Please complete the following:

Evaluation was provided by:



Services, if any, that were recom:mended:

NO, this student has never been evaluated.

Sibling Information (voluntary, not required)

List the name birth date, gender and September 2009 grade level of siblings of the student applying to Green Tech High Charter School (Responding to this question is voluntary and will not affect admissions in any way):

I herebt testify that the information provided on this GTH admission application is accurate and current.

Important Information for Admission: Upon admission, families must provide verification of residency, a copy of the student's prior year academic record, birth certificate and immunization record. In addition, student registration forms, lunch program applications and transportation forms must be completed.

APPLICATION DEADLINE: April 1, 2009 5:30 p.m.