Application for Enrollment

Application for 2019-20 Enrollment

Memphis College Prep is currently accepting applications for incoming Kindergarten through fifth grade students.

STUDENT INFORMATION

Student Name:

Telephone:

Home Address:

Gender:
MaleFemale

Birthday:

Does the student currently receive Special Education services under an Individualized Education Plan (IEP) or 504 Plan?
YesNo

What grade will the student be entering in the 2019-20 school year?

(Per state law, students must be 5 years old on or before August 15, 2019 to enroll in Kindergarten. However, students who will not turn 5 on or before August 15, 2019 may be considered for early entrance into Kindergarten. Click here to learn more about early entrance.)

KindergartenFirst GradeSecond GradeThird GradeFourth GradeFifth Grade

What school is the student currently enrolled in?

Has the scholar ever been retained or held back?
YesNo

What grade is the scholar currently in?
Not currently enrolledDaycarePre-kKindergartenFirst GradeSecond GradeThird GradeFourth GradeFifth Grade

FAMILY INFORMATION

Primary Parent

Name of parent/guardian:

Relationship to applicant:

Home Address:

Mailing Address (if different):

Telephone:

eMail Address:

Other Parent

Name of parent/guardian:

Relationship to applicant:

Home Address:

Telephone:

Please provide the following information about the applicant’s siblings. Please remember that each child will need to submit a separate application for enrollment.

How did you hear about Memphis College Prep Elementary School?

APPLICANTS PLEASE NOTE:
It is the responsibility of the applicant to guarantee all information is accurate. You must notify Memphis College Prep Elementary if your contact information changes. All applications must contain a live signature (not a copy or fax). Only one application may be submitted for each student applying. All questions should be directed to Brittany Dolan, Director of Operations, at 901-620-6475.

Application submission does not guarantee admission to Memphis College Prep. Memphis College Prep is tuition-free and there are no fees to apply. Memphis College Prep does not discriminate on the basis of race, color, gender, handicap, age, religion, sexual orientation, or national or ethnic origin.

Check this box to acknowledge this note.

TYPE YOUR NAME TO SIGN THIS THIS APPLICATION:

Spaces are limited and are processed in the order received.

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