Application for Admission 	Princeton Charter School
2010-2011 Academic Year	100 Bunn Drive, Princeton, NJ 08540
Application deadline: January 6, 2010	Telephone (609) 924-0575
Apply by FAX: (609) 924-7450	http://www.pcs.k12.nj.us 

Student's Name  				
	first	middle	last
Birth Date    		
	month 	day	year
Current School   
Current Grade (2009-2010)   __Pre-K	__K	__1	__2	__3	__4	__5	__6	__7	(mark one)
Are You a Resident of:	___Princeton Township   or	___Princeton Borough?	(mark one)
If other municipality, please specify 
Note: Princeton Township and Borough residents have priority over other applicants; based on the number of resident applicants in previous years, it is unlikely that offers will be made to non-residents. 
Name of Parent/Guardian	
Address					
	street	city		 zip code
Telephone		
	home	work or cell
E-mail	 
Name of Parent/Guardian	
Address	
	street	city		 zip code
Telephone	 	  
	home	work or cell
E-mail	
Emergency Contact Information (in the event we cannot contact parents/guardians at above numbers)
Name	
Telephone		 
	home	work or cell
Please list any siblings who are enrolled in PCS, on the waiting list, or applying for admission this year.  Note:  You must submit a separate application for each child applying this year.
Name	 	Current school /grade 
Name		Current school /grade 
Name	 	Current school /grade 
Note:  All applications must be received by 3:00 pm, Tuesday, January 5, 2010. All information on this application will be treated as confidential. The admissions lottery will be held January 11, 2010. Notification will be mailed within 10 days. Applications received after the deadline will be included in the late-applicant lottery held the last week in May.  Acceptances of admission offers must be received at PCS by 3:00 pm, February 12, 2010. 

Signed:		
	parent or legal guardian	date
Late Applicant Lottery Deadline: 3:00 pm, Monday, May 19, 2010.
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