Application for Adn1ission 2015/16 I Aplicacion Para Admision 2015

Application for Adn1ission 2015/16 I Aplicacion Para Admision 2015

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Application for Adn1ission 2015/16 I Aplicacion Para Admision 2015/16
Applications for the 2015/2016 school year are due by March 20th, 2015.
The PCA lottery will take place at Polaris on Wednesday, March 25th at 9:00 a.m.
If your family is new to Polaris Charter Academy, only complete Part A of this application.
If you have one or more children already attending Polaris Charter Academy, complete Parts A and
B of this application.
PART A:
(1) Student Information/ Infonnaci6n del Estndiante
Student's Legal Name/ Nombre del Estudiante:
Firstl Nombre
Middle/ Segundo nombre
Birth Date/ Fecha de Nacimiento:
Month/ Mes _ _ __
Q Female/ Mujer
Lastl Apellido
Day/ Dia _ _ __
Year/ Ano _ __
Q Male/ Hombre
Current Grade Levell Grado Actual _ _ _ _ __
Grade level for Aug. 2015/ Grado a cursar en agosto del 2015 _ _ _ _ _ _ _ _ (K, 1, 2, 3, 4, 5, 6, 7, 8)
(2) Family Information/ Infonnacion de la Fan1iha:
Sibling Information/ Informaci6n sobre los hermanos:
Please provide the names of the applicant's siblings, if any, who are also applying to Polaris Charter
Academy. Please note a separate application must be completed for each child who is applying to
Polaris Charter Academy
1. Sibling Name/ Nombres: - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Current Grade Levell Grado Actual _ _ _ _ __
Grade level for Aug. 2015/ Grado a cursar en agosto del 2015 _ _ _ _ _ _ _ _ (K, 1, 2, 3, 4, 5, 6, 7, 8)
2. Sibling Name/ Nombres: - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Current Grade Levell Grado Actual _ _ _ _ __
Grade level for Aug. 2015/ Grado a cursar en agosto del 2015 _ _ _ _ _ _ _ (K, 1, 2, 3, 4, 5, 6, 7, 8)
(3) Parent Infor1nationl Inforn1aci6n de los Padres
Relationship/Parentesco - - - - - - - - - - - - - - - - - - - - - - - - - - - - - · - - - Full Name/ Nombre completo - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - First/ Nombre
Middle/ Segundo Nombr Last/ Apellido
Home Address/ Direcci6n - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - City/ Ciudad - - - - - - - - - - S t a t e / Estado _ _ _ _ Zip Code/ C6digo _ _ _ _ _ _ _ _ _ __
Home phone/Telefono _ _ _ _ _ _ _ _ _ _ Cell phone/ Celular - - - - - - - - - - - - - - - Email _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Jc ________________________
Parent/Legal Guardian Signature/ Firma de Padres/Guardian
Date/ Fecha
PART B:
Name of sibling who already attends Polaris Charter Academy
Current Grade Level _ _ _ _ _ _ __
Current Room N u m b e r - - - - - - - - - - - - -
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Application Process
Polaris Charter Academy is currently accepting kindergarten through eighth grade student applications
for the 2015-2016 school year. Any student who lives with in the Chicago city limits is eligible to apply
to Polaris Charter Academy. Enrollment is limited to 50 students per grade level. If grades are fully
enrolled, applicants will be placed on our waiting list in the event a current student transfers.
If your child is eligible to enroll at Polaris the following criteria will need to be met to complete
enrollment:
Parents I guardians must provide a copy of the student(s) birth certificate, proof of Chicago
residency and completion of all enrollment forms
Parents I guardians must be committed to helping their child be successful at Polaris Charter
Academy, which includes overseeing the completion of all homework assignments, getting their child to
school on time everyday in uniform and helping their child adhere to Polaris Charter Academy rules and
policies.
A non- refundable PCA activities fee of $200 will need to be paid within 30 days of enrolling.
To download a Student Enrollment Application for School Year 2015-2016 to participate in the lottery process, click
here. For more information on the lottery, please go to our lottery page for an overview.
If you are interested in transferring to Polaris in the 2015-2016 school year or have questions regarding
the application process, please contact Towanya Sandifer at 773-534-0820.
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Polaris Charter Academy
620 N Sawyer Ave
Chicago, IL 60624
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