Boca Raton Charter School is a world authorized International
Baccalaureate School that offers the Primary Years Program.
To apply please print this application,
sign, date and send to the address listed below.
I. Student Application Form
Child’s Name
First__________________________________ Middle______ Last ______________________________________________ Address ___________________________________________ City__________________________State________Zip______
Gender
( ) Male ( ) Female
Soc. Sec. Number___________________________ Age_______
Date of Birth ______Place
of Birth______________________ Home Language ___________________________________
Application for FY 2016/2017 ___ Grade
Level: (Check one) ( ) Pre kindergarten [ age 3 or 4 and potty trained] ( ) Pre kindergarten Voluntary Pre-k [ age
4 on or before September 1st, FY___ 2016-2017 ] ( ) Kindergarten [must be
age 5 on or before September 1st [FY 2016/2017] ( ) 1st Grade ( ) 2nd
Grade ( ) 3rd Grade ( ) 4th Grade ( ) 5th Grade II. Parent Information:
Mother Information:
Name _______________________________________ Address ______________________________________________ City ___________________________State______
Zip________
Phone Numbers and Contact Information:
Home(_____)_________________Alternate (_____)__________
Business (_____)_________________ Cell (_____)___________ Fax (_____)_____________ Email_________________________
Father Information:
Name __________________________________ Address______________________________________________ City____________________________State______ Zip_______
Phone Numbers and Contact Information:
Home
(_____)_________________Alternate (_____)__________ Business (_____)_________________ Cell (_____)____________ Fax
(_____)________________ Email ______________________
Phone Numbers and Contact Information:
III. Previous
School:
( ) NA ( ) Public ( ) Private ( ) Home School
International Baccalaureate ( ) Yes ( ) No
Current School or Designated Palm Beach County School
Name of School ______________________________________ Address____________________________________________ City ____________________ State ________Zip _________
Does your child have an L.E.P. Plan? Yes ___ No ____ (Limited English Proficiency) Is a language other than
English spoken at home? Spanish __ Portuguese ___ French ___ Creole ___ Other _________________________________
Does the student
have a first language other than English?
Yes ___ No ____ Does the student most frequently speak a language other than
English? Yes ___ No ____ Previous School: Contact
Information
Telephone Number(____)_______________________________ Fax Number (____)_____________________________________
Grade Level attending in _______ 2016-2017 Parent/Guardian Signature___________________________ Date:____________________
Print
and complete this form. Mail to the school at the address below. Boca Raton Charter School * 6001 Park of Commerce
Blvd.* Boca Raton, Florida 33487 Or
you can scan and email your application to [email protected]
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