Rosalyn Yalow Charter School
ONLY FILL OUT THIS FORM ONCE. If you made a mistake, please contact us by filling out the Contact form on this web site.
School year applying for (starting in September):* ---20202021
Note: A separate application must be completed and submitted for each child applying for admission.
Student Information
School District (or New York City Community School District), select "unknown" if you don't know* Please choose one123456789101112131415161718Unknown
Grade Applying for* Please choose oneKindergartenFirst GradeSecond Grade
Does the applicant student have a sibling(s) who is applying to this charter school? * ---YesNo
List the siblings' name, current grade and date of birth below:*
Parent/Guardian Information:
Parent First Name*
Parent Last Name*
Address*
Address 2
City*
State*
Zip*
Email (type "none [email protected]" if you don't have an email)*
Home Phone Number*
Cell Number*
Acceptance: By signing below, you agree that your electronic signature is the legal equivalent of your manual signature on this application.
Parent Signature* [signature signature-23 class:wpcf7-form-control-signature-body]
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, 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.
*Required field