EmailMe Form - RWPCS New Student Enrollment Form SY19-20

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Parents/Guardians: Parents/Guardians: If you participated in the My School DC lottery, please complete this form to confirm your
child accepts a seat in a My School DC school and submit it with other enrollment requirements to the school in
person.

Student Information: You must fill out one form for each child you are enrolling

Student Name *

First Middle Last

Date of Birth *

MM / DD / YYYY

Current Grade (2018-19Y): *

Enrolling Grade (2019-20SY): *

Parent/Guardian Information: Should be the person completing the form and confirming residency.

Name *

First Last

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

RECORDS RELEASE: Please read and check each box below to confirm your enrollment for the 2019-20SY.

Records Release: *Please check the required box below so that Richard Wright PCS may request your child's records.*

I hereby authorize the enrolling school to request records from the current school for the student above. I also hereby authorize the enrolling school to request records from any other previous schools that the student above has attended. I understand that the enrolling school will not further transfer or communicate the records to any other party or agency without my express written consent except under authority of the Family Educational Rights and Privacy Act (FERPA) (20U.S.C. § 1232g; 34 CFR Part 99). *

By signing this form, I authorize the enrolling school to request records from the current school for the student above. I also hereby authorize the enrolling school to request records from any other previous schools that the student above has attend

ENROLLMENT CONFIRMATION: Please read and sign the bottom of this form to confirm your understanding of each statement and your child’s enrollment for 2019-20. *

I understand that I cannot maintain enrollment at more than one school for 2019-20 and I am confirming my enrollment at the “Enrolling School” above.

I understand that once this form is submitted, I will give up my space at my current school for next school year (2019-20) and my current school will be notified that my space may be awarded to another family.

I understand that if I enroll as a result of receiving a waitlist offer from this school that I will be removed from the waitlists of all schools ranked below this school on my My School DC application.

Parent/Guardian Signature *

Clear

Parent/Guardian Electronic Signature (Name of Person Completing and Signing the Form) *

Date Time *

MM / DD / YYYY

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Parents/Guardians: Parents/Guardians: If you participated in the My School DC lottery, please complete this form to confirm your child accepts a seat in a My School DC school and submit it with other enrollment requirements to the school in person.

Student Information: *You must fill out one form for each child you are enrolling*

Parent/Guardian Information: *Should be the person completing the form and confirming residency.*

Parents/Guardians: Parents/Guardians: If you participated in the My School DC lottery, please complete this form to confirm your
child accepts a seat in a My School DC school and submit it with other enrollment requirements to the school in
person.

Student Information: You must fill out one form for each child you are enrolling

Parent/Guardian Information: Should be the person completing the form and confirming residency.