Re-Enrollment

RE-ENROLLMENT FORM FOR 2019-2020

This form is for current students only. To enroll a new student, please download the full application.

Student First Name

Student Last Name

Grade Entering in September

Student Cell Phone Number, if applicable

Student Email Address, if applicable

Parent First Name

Parent Last Name

Home Address

City

State

Zip Code

Cell Phone Number

Work Phone Number

Email Address

Parent 2 First Name

Parent 2 Last name

Parent 2 Cell Phone Number

Parent 2 Work Phone Number

Parent 2 Email Address

Church Affiliation

Church Name

Pastor

Will student need any of these services?
 Early Drop-Off from 7:30a Afterschool from 3p - 5:30p Metrocard Special Tutoring Other

The re-enrollment fee of $100.00 is non-refundable. This form must be completed per child and this fee must be paid per child. Re-enrollment is due by March 15th





On Submit you will be redirected to our secure payment method for the final phase of the re-enrollment.