SYRACUSE ACADEMY OF SCIENCE CHARTER SCHOOL
Online Student Application Form
   
 
  DEAR PARENTS AND APPLICANTS:
  Application Deadline: April 1, 2014. The lottery day for 2014-15 applicants will be on April 4, 2014 at 10am at Syracuse Academy of Science Charter School (1001 Park Ave. Syracuse, NY 13204).

Thank you for your interest in SYRACUSE ACADEMY OF SCIENCE CHARTER SCHOOL. Please fill out this application form completely. Fields marked with * are required!
   
   Applicant's Personal Information
   
      Year Applying: *
  Grade Applying: *
  Last Name: *
  First Name: *
Middle Name:
  Date of Birth: *
  Gender: *
  Street: *
  City: *      State: *      Zip: *
 
Does the student has any documented history of criminal offense or juvenile court adjudication?
if yes, explain:
 
   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 SYRACUSE ACADEMY OF SCIENCE ?
   
   
       
           
 
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.