ReEnrollment Form - Thomas Edison Energysmart Charter School

THOMAS EDISON ENERGYSMART CHARTER SCHOOL
92 Cortelyous Ln
Somerset, NJ 08873
Telephone: 732 412 7643
FAX
: 732 412 7645
Date: January 15, 2015
RE: Re-Enrollment Forms
Dear Parent(s);
Thank you for your support in TEECS. Due to limited space for the upcoming year, we ask each
parent/guardian to fill out the attached form completely. This form is designed for currently
enrolled students. The final closing date for this application is February 27th, Friday 2015
Applications received unsigned, incomplete, or after the closing date may not be considered for
next year.
If student is currently enrolled at TEECS and has a sibling whom will be attending Kindergarten
for 2015-2016 academic year, he/she is qualified for pre-registration. Please provide the sibling's
information on the application attached for Re-Admission. Siblings Registration is for Kindergarten
only. All paperwork for the kindergarten sibling must be handed in by February 27, 2015 in order
to reserve a seat for the 2015-2016 academic year.
Sincerely,
Oguz Yildiz
Lead Person
THOMAS EDISON ENERGYSMART CHARTER SCHOOL
92 Cortelyous Ln.
Somerset, NJ 08873
Telephone: 732 412 7643
FAX
: 732 412 7645
APPLICATION FOR RE-ADMISSION FOR THE ACADEMIC YEAR 2015-2016
Final Deadline February 27th , 2015
DEAR PARENTS AND APPLICANT:
Thank you for your support in Thomas Edison Energysmart Charter School. Due to
limited space for the upcoming year, we ask each parent/guardian to fill out this
re-enrollment form completely. This application form is designed for currently
enrolled students. The closing date for this application is FRIDAY , FEBRUARY
27TH, 2015. Applications received incomplete, or after the closing
date may not be considered for next year.
FOR OFFICE USE ONLY
Date Application Received: _________________
Application #: _________________
Student's name: ____________________________________, _____________________________________, _____________________________
(Last)
(First)
(Last)
(First)
(Middle)
Sibling’s Name:
(Middle)
Grade (2015/2016)
Parent/Guardian’s Name: ____________________________________, _______________________________ __________________________
(Last)
Guardian’s relationship to student : Mother
Student lives with
:
(First)
(Middle)
Father Sister/Brother Other: ______________________
Mother Father Both
Other: ______________________________
Permanent address: _____________________________________________________________________________________________________
(Street & House/Apt. No.)
_____________________________________________________________________________________________________
(City)
(State)
(Zip Code)
Phone: (_______)_______________________
(_______)_______________________
(Work)
(_______)__________________________
(Other)
Cellular: (_______)___________________
Fax: (_______)__________________
E-mail: __________________________
(Home)
We/I, the undersigned, hereby certify that, to the best of our/my knowledge and belief, the answers to the foregoing questions and statements made
by us/me in this application are complete and accurate. We/I understand that any false information, omissions, or misrepresentations of facts may
result in rejection of this application or future dismissal of the applicant.
______________________________
____________________________________
Name of Parent or Guardian
______________________________
Signature of Parent or Guardian
Date
Please e-mail the completed application to: Front Office (Thomas Edison Energysmart Charter School)
92 Cortelyous Ln
Somerset, NJ 08873
Telephone: 732 412 7643
Email: [email protected]
FAX
: 732 412 7645
WEB: www.energysmartschool.org
Final Deadline February 27th , 2015
Thomas Edison Energysmart Charter School admits students without regard to race, color, religion, gender, national and ethnic origin, or the presence of a medical condition or
disability.