Creativity CoLaboratory Charter School Enrollment FormCreativity CoLaboratory Enrollment Form Student InformationPlease complete this Enrollment Form for each student.Student First Name*Student Last Name*Birthdate* Month Day YearGrade*5th6th7th8th2021-2022 School YearT-Shirt Size*XSSMLAdult Sizes XS - LStreet Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Mailing Address (if different from Street Address) Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Current School*Home School District*Gender*What is your preferred method of transportation for your student?*School BusPersonal VehicleRace/Ethnicity* White Black Hispanic Indian/Alaskan Asian/Pacific IslanderCurrent Meal Status*FreeReducedPaidDoes the Student have an IEP?*YesNoDoes the Student receive ESL, ELL, or Bilingual Services at current school?*YesNoParent/Guardian Submitting this FormParent/Guardian First Name*Parent/Guardian Last Name*Relationship to Student*Phone*Email* Second Parent/Guardian2nd Parent/Guardian First Name2nd Parent/Guardian Last NameRelationship to Student2nd Phone2nd Email Media ReleaseBy submitting this form, I, the above listed Parent/Guardian with legal custody, authorize Creativity CoLaboratory Charter School and its agents to have and use video, audio recording, or images of the student described, or of the student’s performances, artwork, literary work or letters to Creativity CoLaboratory Charter School, as may be needed for its records, public relations, or promotional materials.Enrollment Agreement AgreeBy submitting this form, I, the above listed Parent/Guardian with legal custody, confirm that my child is enrolled at Creativity CoLaboratory Charter School for the 2021-2022 school year.
