Robla New Hope Charter School

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2024-25 Enrollment Interest form K-6

Student Information

Legal First Name*

Answer Required

Legal Middle Name

Answer Required

Legal Last Name*

Answer Required

Preferred Name

Answer Required

Grade Entering*

Answer Required

Date of Birth*

Answer Required

Address

Street Address*

Answer Required

City*

Answer Required

Zip/Postal*

Answer Required

Home Phone

Number Required

Parent 1 Information

First Name*

Answer Required

Middle Name

Answer Required

Last Name*

Answer Required

Email*

Answer Required

Mobile Phone*

Number Required

Work Phone

Number Required

Parent 2 Information

First Name

Answer Required

Middle Name

Answer Required

Last Name

Answer Required

Email

Answer Required

Mobile Phone

Number Required

Work Phone

Number Required

Emergency Contact Information

First Name

Answer Required

Middle Name

Answer Required

Last Name

Answer Required

Relationship to Student

Answer Required

Email

Answer Required

Phone Number

Number Required

Confirmation Email

Confirmation Email

Email Required