Richard Allen Preparatory - Re-Enrollment Form

Please Fill Out The Re-Enrollment Form Below

Student First Name

Student Last Name

Student Date of Birth

Current Grade

Grade 5

Grade 6

Grade 7

Home Address

Address

City

State / Province / Region

Zipcode Min: 1 Max: 5

Country

Home Phone Number

Daytime Phone Number

Parent/Guardian Name(s)

Email Address

Does the student have a sibling applying to RAPCS?

Yes

Sibling Name

Grade Sibling Applying To

Grade 5

Grade 6

Grade 7

Grade 8

By checking this box in the affirmative, I certify that the information given is true and correct to the best of my knowledge. I also certify that I am legally able to enroll this student in school.

I agree with the above statement

The charter school will not discriminate against any applicant for employment or admission, in any way that is illegal based on Pennsylvania Law or Pennsylvania Department of Education standards, including race, religion, gender, age, status as a person with a disability, proficiency in the English language, or academic aptitude.

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