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									                                                       Application deadline is Friday, August 14, 2009 at noon

                   Nuestro Mundo Community School                                    Instructions: Complete Application & Internal Transfer (if applicable) and mail to
                   KG-5th Grade Application for Enrollment Consideration                                  Attn: Daniela Ocampo, 4201 Buckeye Rd, Madison, WI 53716
                   2009-10 Academic Year                                                   If you live outside of the Attendance Zone you must complete an Internal Transfer Form


                                                                    STUDENT INFORMATION
Name Last, First, Middle Initial                                                      Date of Birth                                 Grade Entering (Must be 5 prior to Sept 1st for KG)
                                                                                                                                   □ KG □1st □ 2nd □ 3rd □ 4th □ 5th
Address Street, City, State, Zip                                                                                               Do you live in the attendance Zone
                                                                                                                                              □ YES □ NO
                                                                                                                If you do not live in the attendance zone please fill out the Internal Transfer form
Parent/Guardian Name                                                                            Home Phone                      Work Phone         Cell Phone
                                                                                                (  )                            (   )              (    )
How did you hear about Nuestro Mundo?                                              Email                                          Best Way to Contact Parent/Guardian
                                                                                                                                   □ Email □ Home Phone □ Cell Phone
Reasons I am considering Nuestro Mundo for my child (check all that apply)
□ I want my child to retain his/her Spanish                      □ I want my child to learn to speak/ write / read Spanish
□ I want my child to be in a multi-cultural school setting       □ My child lives in a bilingual home
□ My child has been in a bilingual preschool/ childcare program  □ My Child has been in a dual-language immersion school
□ Other _________________________________________________________________________________________________________
                                                                      PRIMARY LANGUAGE
   Your child's primary language is an important component to his/her class placement at Nuestro Mundo. In order so have success with dual-immersion it is
                                 essential to balance the class composition between Spanish speakers and English Speakers.
                                                        LANGUAGE SPOKEN BY ADULTS AT HOME
                 □ All Spanish □ Mostly Spanish/A little English □ Half/Half □ Mostly English/A little Spanish □ All English □ Other Language
Comments:
                                                             LANGUAGE SPOKEN BY YOUR CHILD
                 □ All Spanish □ Mostly Spanish/A little English □ Half/Half □ Mostly English/A little Spanish □ All English □ Other Language
Comments:
                                                                   COMMITMENT TO SCHOOL
Our goal at Nuestro Mundo is to insure the success of your child's bilingual education. In order for this goal to be met it is important that your child remain in our
                     school for his/her entire elementary school experience. Please sign below indicating your commitment to this goal.


Sign: ____________________________________________________________________________                                                         Date:___________
                                                                     FOR OFFICE USE ONLY
Date Received:                                                                                  Internal Transfer Form Received                           □ YES □ NO □ N/A

								
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