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ICS-West 2018-19 1st-5th Grade Application
This is the application for the Independence Charter School-West (56th & Chester) 2018-2019 Student Lottery for 1st-5th grades only.
Please read the application instructions on our website before submitting your application.
You may only submit one application per child. All duplicate applications are invalid. (Please DO NOT click the "Submit" button twice.)
You must submit a separate application for each child.
It is your responsibility to retain your email receipt for your records. If you do not receive your email receipt, please contact codys@icswest.org
Select the grade that your child will be entering in September 2018.
*
Please select
1st
2nd
3rd
4th
5th
Your child will be entered into the lottery drawing for the grade selected.
Student Name
*
First
Middle
Last
Type full name exactly as it appears on birth certificate.
Student Street Address
*
Philadelphia, PA
Zip Code
*
Which catchment area does student live in?
*
Sayre
Bartram
Overbrook
Other
If you are unsure please check school finder on the school districts website at the following link:
https://webapps1.philasd.org/school_finder/
Student Birth Date
*
MM
/
DD
/
YYYY
Please list the name of your child's current school
Parent/Guardian #1 Name
*
First
Last
This parent/guardian must live at the same address as the student.
Parent/Guardian #1 Email
*
This email address will receive an email receipt of this application.
Please retype email to confirm
Primary Phone
*
###
-
###
-
####
Parent/Guardian #2 Name (if applicable)
First
Last
Parent/Guardian #2 Email
Phone
###
-
###
-
####
Parent/Guardian #2 Street Address (if not the same as student's)
City, State, Zip
Does this student have siblings in the same household who currently attend ICS-West and will still be enrolled at ICS-West in 2018-2019?
*
Yes
No
If yes, list sibling full name(s).
Does this student have siblings in the same household for whom you are also submitting 2018-2019 ICS-West lottery applications?
*
Yes
No
If yes, list sibling name(s) and grade(s) they are entering in 2018-2019. Remember that you will need to submit a separate application for each sibling.
Remember that you must submit a separate lottery application for each sibling.
*
By typing my name below, I am confirming that all information on this application is true. I understand that if I have falsified any information on this application, the application will be null and void.
*
I understand that if selected for enrollment, I will be required to submit proof of Philadelphia residency and proof of child’s age.
Your Name
*
First
Last
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