ENROLLMENT APPLICATION
Thank you for your interest in Arco Iris Spanish Immersion School! Please fill in the below form for the 2010 – 2011 school year. This form allows you to convey your intentions of having your child try for placement in one of the 1st – 4th grade classes. Open Enrollment begins January 6, 2010, and closes March 12, 2010. If we have more students apply than we have space, a lottery system will be used and you will be notified after Open Enrollment has ended. You are encouraged to apply even after open enrollment has closed as some slots may open up before the school year actually begins. A Waiting List will also be maintained.
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Sincerely,
Arco Iris Spanish Immersion School
________________________________________________________________________________________________________________________
Parent Name:_____________________________ Email Address:___________________________________
STUDENT INFORMATION
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1. LEGAL LAST NAME
| 2. LEGAL FIRST NAME | 3. MIDDLE NAME
| 4. SUFFIX | 5. GENDER
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6. USUAL LAST NAME | 7. PREFERRED FIRST NAME
| 8. DATE OF BIRTH | 9. AGE | 10. HOME TELEPHONE NUMBER ( )
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11. HOME ADDRESS | 12. APARTMENT NUMBER & COMPLEX NAME
| 13. CITY | 14. STATE | 15. ZIP
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16. IS MAILING ADDRESS SAME AS HOME ADDRESS? YES NO (IF NO, PLEASE COMPLETE BOXES 17-20)
| 17. DIFFERENT MAILING ADDRESS | 18. CITY | 19. STATE | 20. ZIP |
21. PREVIOUS SCHOOL DISTRICT ATTENDED
| 22. PREVIOUS SCHOOL ATTENDED | 23. PREVIOUS SCHOOL ADDRESS | 24. DATES ATTENDED |
25. COUNTRY OF BIRTH
| 26. CITY OF BIRTH (IF IN USA) | 27. STATE OF BIRTH (IF IN USA) |
28. School Boundary of Residence: | 29. Last Grade Completed? |
| | | | | | | | |
HOME LANGUAGE SURVEY
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IS A LANGUAGE OTHER THAN ENGLISH SPOKEN AT HOME? YES NO IF YES, INDICATE LANGUAGE______________________________________________________________________________ IF YES, YOUR CHILD’S ENGLISH ABILITY WILL BE ASSESSED. ENGLISH AS A SECOND LANGUAGE SERVICES WILL ONLY BE PROVIDED IF STUDENT IS ELIGIBLE. For Office Use: Mailed / Dropped off Returned on _______________.
(circle one) (Date)
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Arco Iris adheres to a policy of racial nondiscrimination in the admission of students. It admits students of any race, color,
national and ethnic origin to all the rights, privileges, programs and activities generally accorded or made available to students
at Arco Iris.
The school does not discriminate on the basis of race, color, national and ethnic origin in the administration of its student
admissions policies, employment policies, educational policies, grant and scholarship programs and athletic and other
school administered programs.
Please mail to Arco Iris Spanish Immersion School | 11815 SW Terra Linda Street | Portland OR 97005