Somerset Academy Silver Palms
****A K-12 Miami Dade County Tuition Free Public Charter School ****FCAT Saturdays, January 7-April 14, 2012****
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Registration Application
Please complete the form below. Mandatory fields marked
*
Application For School Year 2012-2013
Date:
*
Fecha
MDCPS Student ID#:
*
Numero de Estudiante
Grade Applying for:
*
Grado para el cual esta aplicado
Student Name:
*
Nombre Del Esudiante
Date of Birth:
*
Fech de Nacimiento
Current Grade:
*
Grado Actual
Last School Attended:
*
Escuela Actual
Parent/Guardian Name:
*
Nombre del padre o tutor
Address:
*
Direccion
City:
*
Ciudad
Zip Code:
*
Codigo Postal
Home Phone:
*
Telefono de la casa
Work Phone:
*
Telefono del trabajo
Cell Phone:
*
Cellular
Other:
*
Otro
Do you have another son/daughter registered at Silver Palms?
Usted tiene otro hijo/hija matriculado en Silver Palms?
Yes/
Si
No/
No
If yes, please write: Name
Si responde Si ponga: Nombre
Grade Level:
Grado
If yes, please write: Name
Si responde Si ponga: Nombre
Grade Level:
Grado
If yes, please write: Name
Si responde Si ponga: Nombre
Grade Level:
Grado