BELOVED COMMUNITY CHARTER SCHOOL

A Free Public School For All

Dear Parent or Guardian:

Thank you for your interest in enrolling your child at Beloved Community Charter School.

Beloved Community Charter School is a free public school that provides equal access to all students, regardless of intellectual or athletic ability, measures of achievement or aptitude, and status as a handicapped person.

The school was established in 2011 for grades Kindergarten through Second. Each year we will add a grade and we plan ultimately to have a grade school, middle school and high school. For the school year that will begin in September 2015, we will be enrolling 120 new students in Kindergarten and several students in each of the following grade levels: First Grade through Fifth.

To apply for enrollment, please: 1) COMPLETELY fill out this Application for Admission; 2) sign it, and 3) return it to us, together with a copy of your child'sbirth certificate and proof of address for the student. (Legally accepted proofs of address include utility bills, letters from any government entity, bank statements, leases, mortgage statements, car registration or car insurance. Drivers Licenses and cell phone bills are NOT acceptable.)

Because we expect to receive more applications than there are seats available, New Jersey law stipulates that we hold an admissions lottery. Students can only be entered into the lottery when all documentation is in hand. So please apply right away and get us your child’s birth certificate and proof of home address as soon as possible.

Our INITIAL APPLICATION DEADLINE is November 15, 2014. If we need to hold a lottery, it will be held on November 19, 2014. We will continue to accept applications after that date to fill remaining seats, if any. Once the roster is filled, new applicants will be placed on a wait list on a fist come first serve basis.

Please return your completed application with documents to the school located at 508 Grand Street, Jersey City, NJ 07302 any school day between the hours of 8:00 and 5:30

For Kindergarten applicants: Please be aware that Kindergarten applications will only be valid if your child turns five on or before October 1, 2015.

Submit One Application for Each Child: Only one application per child will be accepted. If you have more than one child applying for admission, complete a separate application for each child.

E-mail Address Please be sure to include your email address on the application as this is one of our primary means of communication.

Open Houses: To learn more about Beloved Community Charter School, please attend a Parents Open House. Dates and times will be listed on our website: BelovEDccs.org.

Lottery Results: You do not need to attend the lottery to participate, although you are welcome to. You will be notified of the lottery results via the contact information you provide on the application.

If your child was on the 2014-15 school year wait list, you must reapply for the 2015-16 school year. Wait Lists cannot be carried over beyond the school year applied for.

If you have any questions, please do not hesitate to call us at 201-630-4700.

www.belovedccs.org

APPLICATION FOR ADMISSION ______(Reference)

1.  Grade Information

What grade will this student enter in September 2015? K ___; (1) ___; (2) ___; (3) ___; (4) ___; (5)___ (Check One)

2. Student Information

Student’s Name: ______

(Last) (First) (MI)

Birth Date: ______/______/______ Gender: M F

(month) (day) (year) (Circle One)

3.  Student’s Current School (Complete only if your child is currently attending a school.)

Current School Name: ______Current Grade: Pre-K K 1st 2nd 3rd 4th (Circle One)

4.  Custodial Parent/Guardian Info Relationship to Student: Mother ___ Father ___ Guardian ___ (Check One)

First Name: ______Last Name:______

Address:______

(Street Address, Apt #) (City) (State) (Zip)

Home Phone:______Work Phone:______

Cell Phone:______Other Phone:______

Email 1:______Email 2:__________

(Please provide multiple phone numbers and email addresses. It is VERY important that we be able to reach you.)

5. Brother or Sister Applying (If more than one sibling is applying, attach an additional page.)

Name: ______Age: ___ Current Grade: Pre-K K 1st 2nd 3rd 4th (Circle One.)

(Remember to complete a separate application for each prospective student.)

Identify any sibling of the applicant who is currently enrolled at BCCS_______

6.  Parent Signature

I am applying to have my child attend BeloveED Community Charter School in Jersey City. I certify that the statements and information I am providing in this application are true, accurate, and complete. I understand that BelovED features a longer school day, a strong discipline code, uniforms, and parent involvement. I understand that prospective students are chosen by a lottery. I also understand that if my child is not initially selected in the lottery, s/he will be placed on a waiting list for the year. If spots open up during that year, students will be admitted from the waiting list in the order in which they were selected. I hereby request that you consider this application for the next and any subsequent lotteries that are used to fill possible BelovED openings for the 2015-16 school year.

______

Parent/Guardian Signature Date