Student's First Name (Nombre) *

Student's Last Name (Apellido) *

Grade Next Year (Grado próximo año) Pre-K K 1st 2nd

Current School (Colegio actual) Al & Jean's Inc. (912 South Avenue) Barlow Elementary (2 Farragut Road) BUF-Health & Human Services (403 W. 7th Street) BUF II (510 Grant Avenue) Cedarbrook Elementary (1049 Central Avenue) Clinton Elementary (1342 West 4th Street) Cook Elementary (739 Leland Avenue) Dawn to Dusk Childcare Center (1504 W. Third Street) Emerson Elementary (305 Emerson Street) Evergreen Elementary (1033 Evergreen Avenue) H.O.P.E.S. Head Start – Plainfield (Watchung: 7-9 Watchung, 3rd Floor) H.O.P.E.S. Head Start – Plainfield (St. Marys: 513 W. 6th Street) H.O.P.E.S. Head Start – Plainfield (New Horizons: 110-128 W. Front Street) Jefferson Elementary (1750 West Front Street) The King's Daughters Day School (502 W. Front Street) Little Hearts Learning Centers (400 Cleveland Avenue) Little Hearts Learning Centers (631 E. Front Street) Neighborhood House Association East (321 E. Front Street) Neighborhood House Association West (644 W. 4th Street) Plainfield Bilingual Day Care Ctr (225 W. 2nd Street) Playhouse Child Development Ctr (1101 South Avenue) Precious Steps (20 Washington Avenue) Precious Steps Too (516-522 Arlington Avenue) SSYC – Preschool (935 So. 2nd Street) Stillman Elementary (201 West 4th Street) Washington Comm. School (427 Darrow Avenue) Washington Elementary (427 Darrow Avenue) Woodland Elementary (730 Central Avenue) Other

Date of Birth (Fecha de nacimiento) *

Sex (Sexo) *
 Male    Female

Parent's First Name (Nombre) *

Parent's Last Name (Apellido)*

Relationship to Student (Relación) Mother Father Legal Guardian Other

Cell Phone (Celular) *

Home Phone (Casa) *

Work Phone (Trabajo)

Email Address (Correo electrónico)

What is the best way to contact you? (Cuál es la mejor manera de contactarle?)
 Mail/Correo    Email/Correo electrónico    Cell/Teléfono Celular    Home/Teléfono de la casa    Work/Teléfono de su trabajo

Street Address (Calle) *

Apt # (Apt)

City (Ciudad) *

Zip Code (Código Postal)

Sibling Policy: Preference is given to siblings of enrolled students (NJSA 36A - 8C). Please list any siblings (brothers / sisters) applying for or enrolled at Cresthaven Academy.
Póliza de hermano: Preferencia es otorgada a hermanos (a) de escolares matriculados (NJSA 36A-8C). Por favor de listar algun hermano (a) que está aplicando o que están matriculados en Cresthaven Academy.

Sibling's First Name (Nombre)

Sibling's Last Name (Appellido)

Charter schools are free, open-enrollment public schools that are required by law to serve all students. Charter schools shall be open to all students on a space available basis and shall not discriminate in their admission policies or practices on the basis of intellectual or athletic ability, measures of achievement or aptitude, special education status, proficiency in the English language, or any other basis that would be illegal if used by a school district.

Las escuelas chárter son gratuitas y públicas requeridas por ley de servir a todos los estudiantes. Las escuelas chárter son abiertas a todos los estudiantes basado en el espacio disponible y no discriminará en su proceso o reglas de inscripción basado en habilidad intelectual o atlética, medidas de logros o aptitud, estatus de educación especial, capacidad en el idioma Inglés, u otro base que sería ilegal si usado por el distrito escolar.

Submitting this application does not mean or guarantee that the student will be accepted. By completing this application correctly and notifying us of changes, we guarantee that you will be contacted if the student is accepted through our random lottery process. By clicking here, you are agreeing that the information you provided is true and correct. If the student is accepted because the information is false, we may refuse to enroll the student.

Entregando esta solicitud no significa que el estudiante sera aceptado. Al completar esta solicitud correctamente y notificandonos de cambios, nososotros garantizamos que usted sera contactado si el estudiante es aceptado a travez de nuestro proceso de loteria. Al firmar su nombre abajo, usted esta de acuerdo que la informacion usted ha previsto es verdadera y correcta. Si el estudiante es aceptado porque la información que usted entregó era falsa o incorrecta, podemos rehusar matricular al estudiante.