STUDENT APPLYING FROM FRANKLIN TOWNE ELEMENTARY? Yes No
DOES STUDENT HAVE A SIBLING AT FRANKLIN TOWNE CHARTER HIGH SCHOOL? Yes No
STUDENT INFORMATION:
LAST NAME :
FIRST NAME: MIDDLE INITIAL:
DATE OF BIRTH: SEX: MALEFEMALE
ADDRESS:
CITY: STATE:
ZIP: HOME TELEPHONE:
PARENT/GUARDIAN INFORMATION
STUDENT LIVES WITH: MOTHER FATHER BOTH
GUARDIAN RELATIONSHIP TO STUDENT
MOTHER'S NAME: DAYTIME NUMBER:
FATHER'S NAME: DAYTIME NUMBER:
GUARDIAN'S NAME: DAYTIME NUMBER:
PARENT/GUARDIAN EMAIL ADDRESSS:
CURRENT SCHOOL INFORMATION
SCHOOL CURRENTLY ATTENDING:
CURRENT GRADE: GRADE APPLYING FOR:
SIBLING NAME:
NAME OF PERSON COMPLETING THIS APPLICATION:
DATE: