We’re glad to be a part of your family’s educational journey! Please fill out the form below so we may start the enrollment process.

Please fill out one form for each child you are registering.

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Child’s Name

Grade

Child’s School of Attendance

Will you be using Charter School Funds to pay for services?

Does Your Child Receive Any of These School Services?

English Language Development Special Education Gifted & Talented (GATE) Social / Emotional Supports

1st Parent / Guardian’s / Ed. Right’s Holder’s Name

1st Parent / Guardian’s / Ed. Right’s Holder’s Phone Number

1st Parent / Guardian’s / Ed. Right’s Holder’s Email

1st Parent / Guardian’s / Ed. Right’s Holder’s Address

2nd Parent’s Name

2nd Parent’s Phone Number

2nd Parent’s Email

2nd Parent’s address (if different)

Emergency Contact’s Name

Emergency Contact’s Phone Number

May The Emergency Contact Pick Up Your Child?(required)

Yes

N/A (virtual services only)

Please describe any heath needs that your child has (including allergies)

IES will use the information you provide here only to provide our services. We will never sell your information. The information you provide here is for class enrollment, not for our online payment system.

Family Information

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