Arthur Academy: English Application

Woodburn School District
Enrollment Application for School Year 2010-2011

Please complete a separate form for each student being enrolled. Students will be on a list in the order in which they arrived or in the order of lottery if a lottery is necessary.

School Year You Are Applying For

Grade Your Student Will Be In That Year

School District

Student Name

Date Of Birth

Month

Day

Year

Mailing Address

Current School (if attending)

School

District

If student is not now attending a public school, in which local school and district would student reside in fall of 2011?

School

District

IEP

Does student have an IEP (Individualized Education Program) for special education?

Yes
No

Retained

Has student ever been retained (held back)?

Yes
No

Parent/Guardian Names

Mailing Address (if different)

Telephone

Day

Evening

Cell

Fax

E-mail

Siblings

Please enter names and birth dates of students being enrolled this year or in the future.

Student Name

Date Of Birth

Month

Day

Year

Student Name

Date Of Birth

Month

Day

Year

How did you hear about Arthur Academy?

Additional Comments

Three cut-off dates: April 1st, May 1st and July 1st

(If necessary, a lottery will be conducted on each cut-off date for a given grade.
In-district students and students of siblings already attending must be enrolled first.)

If you do NOT receive a confirmation that your application was received
within 3 days of your submission, then please follow up with us at
info@arthuracademy.org.

Thank you for your interest in our school.