PCSST 2-6
Online Application Form
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DEAR PARENTS AND APPLICANTS:
Thank you for your interest in Paterson Charter School for Science and Technology. Please fill out this application form completely. Falsifications, misrepresentations or omissions may disqualify your application.
Student Information
First Name
Middle
Last Name
Suffix
Date of Birth
Gender
Select Gender
Female
Male
Non-Binary/Undesignated
Academic Year
2021-2022
Grade Applied For
Select
2
3
4
5
6
Student lives with
Select
Both Parents
Mother
Father
Both Parents Alternately
Legal Guardian
Does the applicant student have a
sibling
who is
currently enrolled
in this charter school?
Yes
No
Sibling by definition is a biological/adoptive sibling, step-sibling residing in the same household, or a foster child residing within the same household. In such cases of court orders, documentation may be required.
The following do not qualify for sibling priority:
Step-siblings living in different households.
Cousins, relatives, or friends.
Siblings in a different iLearn network school.
An alumnus of the school with a sibling applying for the following year.
Please note that sibling priority does not guarantee a seat, as enrollment is based on the number of available seats for that particular school year. Please return back to the school in wish you to apply.
Sibling First Name
Sibling Last Name
Grade Entering Next Year
Select
K
1
2
3
4
5
6
7
8
9
10
11
12
Does the applicant student have a
sibling
who is
applying
to this charter school?
Yes
No
Sibling by definition is a biological/adoptive sibling, step-sibling residing in the same household, or a foster child residing within the same household. In such cases of court orders, documentation may be required.
The following do not qualify for sibling priority:
Step-siblings living in different households.
Cousins, relatives, or friends.
Siblings in a different iLearn network school.
An alumnus of the school with a sibling applying for the following year.
Please note that sibling priority does not guarantee a seat, as enrollment is based on the number of available seats for that particular school year. Please return back to the school in wish you to apply.
Sibling First Name
Sibling Last Name
Grade Entering Next Year
Select
K
1
2
3
4
5
6
7
8
9
10
11
12
School Information
Current School Name
(You can type 'First Year' if you are applying for Kindergarten and currently not enrolled in any Pre-K program)
School District
(You can type 'First Year' if you are applying for Kindergarten and currently not enrolled in any Pre-K program)
School Address
Phone
Fax
Primary Parent Information
Relation
Select
Mother
Father
Stepmother
Stepfather
Grand Parent
Aunt
Uncle
Sister
Brother
Legal Guardian
Other
Title
Select
Mr.
Mrs.
Miss
Dr.
Ms.
First Name
Last Name
Address
State
Select
AL
AK
AS
AZ
AR
CA
CO
CT
DE
DC
FL
GA
GU
HI
ID
IL
IN
IA
KS
KY
LA
ME
MH
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PW
PA
PR
RI
SC
SD
TN
TX
UT
VT
VI
VA
WA
WV
WI
WY
City
Select
Zip
Primary Phone
Cell
Home
Work
Secondary Phone
Cell
Home
Work
E-Mail
Secondary Parent Information
Relation
Select
Mother
Father
Stepmother
Stepfather
Grand Parent
Aunt
Uncle
Sister
Brother
Legal Guardian
Other
Title
Select
Mr.
Mrs.
Miss
Dr.
Ms.
First Name
Last Name
Address
Same as Primary Parent
State
Select
AL
AK
AS
AZ
AR
CA
CO
CT
DE
DC
FL
GA
GU
HI
ID
IL
IN
IA
KS
KY
LA
ME
MH
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PW
PA
PR
RI
SC
SD
TN
TX
UT
VT
VI
VA
WA
WV
WI
WY
City
Select
Zip
Primary Phone
Cell
Home
Work
Secondary Phone
Cell
Home
Work
E-Mail
We hereby certify that, to the best of my/our knowledge and belief, the answers to the foregoing questions and statements made by me/us in this application are complete and accurate. I/We understand that any false information or misrepresentations of facts may result in rejection of this application or future dismissal of the applicant.
Yo / Nosotros certificamos que la información declarada en esta aplicación es verdadera, correcta y completa, y las preguntas y declaraciones anteriores hechas por mi / nosotros en esta aplicación están completas y exactas. Yo / Nosotros entendemos que cualquier información falsa o mala representación de los hechos pueden resultar en el rechazo de esta aplicación o el futuro despido del solicitante.