Last Name First Name City State Zip Code Borough Home Phone Email Gender Female Male No Response Date of Birth Hispanic/Latino Ethnicity Hispanic/Latino Response American Indian or Alaskan Native American Race Native Hawaiian/Pacific Islander Other No Response Country Primary of Origin Language English Additional Yes No Proficient Language(s) Student Yes or no: Interested in half-day programming? Yes No Status Student ID / OSIS # School Address Name Teacher/ Current Advisor Grade Level
Last Name First Name City State Zip Code Borough Home Phone Email Gender Response Date of Birth Ethnicity Hispanic/Latino Hispanic/Latino No Response Race American Indian or Alaskan Native American Native Hawaiian/Pacific Islander Response Country of Origin Primary Language English Proficient Yes Additional Language(s) Student Status Interested in half-day programming? Yes or no: Yes Student ID / OSIS # Name School Address Teacher/ Advisor Current Grade Level No No No Female Male Other
FY18-Manhattan-Charter-School-2_Program-Application.docx