Birth Certificate Translated in English by tna55004

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									Application for Admission 2010
This application must be accompanied by a copy of the child’s birth certificate (translated if not in English) and two proofs of
residence. Applicants will be placed on a wait list if classes are full. Children must be 4 years old as of September 1st, 2010 to
enter Pre-Kindergarten. Application deadline: February 26, 2010. Late and incomplete applications will not be considered.

Child                                 Grade applying for:  K1   K2  1   2   3   4   5
______________________________________________________________________________________________
LAST NAME                                                FIRST NAME                                     MIDDLE NAME
______________________________________________________________________________________________
DATE OF BIRTH                                            GENDER                                         CURRENT GRADE (2009-2010)
______________________________________________________________________________________________
ADDRESS                                                  CITY/STATE/ZIP

Parent/Guardian (Please submit proof of guardianship.)
______________________________________________________________________________________________
LAST NAME                                                FIRST NAME                                     RELATIONSHIP
______________________________________________________________________________________________
ADDRESS                                                  CITY/STATE/ZIP                                 HOME TELEPHONE
______________________________________________________________________________________________
EMAIL ADDRESS                                            CELL TELEPHONE                                 WORK TELEPHONE

Other Children Applying to/Attending Conservatory Lab
_____________________________________________________________________
NAME                                                     DATE OF BIRTH
_____________________________________________________________________
NAME                                                     DATE OF BIRTH
_____________________________________________________________________
NAME                                                     DATE OF BIRTH

The Conservatory Lab Charter School does not discriminate on the basis of race, color, national origin, creed, sex, ethnicity, sexual
orientation, mental or physical disability, age, ancestry, athletic performance, special need, proficiency in the English language, or
academic or musical achievement.

Please fill out a separate application for each child.

I am enclosing the following with this application (Incomplete applications will not be considered):

  Child's birth certificate (translated if necessary).                Two proofs of residence.


______________________________________________________________________________________________
CHILD'S NAME
______________________________________________________________________________________________
PARENT/GUARDIAN NAME
______________________________________________________________________________________________
PARENT/GUARDIAN SIGNATURE                                                                               DATE


                                                                                          OFFICE USE ONLY
Please return this completed application form
with supporting materials to:                                                             Date Received: _______________________
Conservatory Lab Charter School
25 Arlington Street                                                                       Siblings:        _______________________
Brighton, MA 02135

For more information call: 617-254-8904                                                   Membership
Fax: 617-254-8909
                                                                                          Begin:      ____________________________
http://www.conservatorylab.org
admissions@conservatorylab.org                                                            End:        ____________________________

								
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