ROCHESTER ACADEMY CHARTER SCHOOL
Online Student Application Form
   
 
  DEAR PARENTS AND APPLICANTS:
  Thank you for your interest in ROCHESTER ACADEMY CHARTER SCHOOL
Application Deadline : April 2, 2012 (for 2012-2013 School Year)
Lottery Date and Location : April 2, 2012 841 Genesee Street
Please fill out this application form.
   
   Applicant's Personal Information
   
      Year Applying: *
  Grade Applying: *
  Last Name: *
  First Name: *
Middle Name:
  Date of Birth: *
  Gender: *
  Street: *
  City: *      State: *      Zip: *
 
   Applicant's School Information
   
  School District: *
 
   Applicant's Family Information
   
         
  Parent: * If Other: *
  Title:    
  First Name: * Last Name: *
  Street:
  City: State:      Zip:
  Home Phone: * Work Phone:
  Cell Phone: Email:
         
  Parent: If Other :
  Title:    
  First Name: Last Name:
  Street:
  City: State:      Zip: 
  Home Phone: Work Phone:
  Cell Phone: Email:
         
 
Does the applicant student have a sibling(s) who is currently enrolled in this charter school? *
  If yes, list at least one sibling’s name, current grade and date of birth: *
         
   How did you hear about Rochester Academy Charter School ?
   
   
       
           
 
Non-Discrimination Statement: A charter school shall not discriminate against or limit the admission of any student on any unlawful basis, including on the basis of ethnicity, national origin, gender, disability, intellectual ability, measures of achievement or aptitude, athletic ability, race, creed, gender, national origin, religion or ancestry. A school may not require any action by a student or family (such as an admissions test, interview, essay, attendance at an information session, etc.) in order for an applicant to either receive or submit an application for admission to that school.

* The items marked with an asterisk (*) are the only items that are required in order to apply. Any items not marked by an (*) are optional.