Dream Dine Student Lottery Application for Enrollment

Receipt #

Please return to Dream Dine Team member or mail to: PO Box 4386 Shiprock, NM 87420

Student Information

Last Name: ______2017/2018 School Year Grade: K ☐ 1☐ 2☐ 3☐4☐

First Name: ______Date of Birth: ______

Middle Name: ______

Does this child have any siblings currently enrolled at Dream Dine? No _____ Yes ______

If yes, what is the sibling’s name? ______

What grade is/are the sibling(s) enrolled in during the 2017-2018 school year? K ☐ 1☐ 2☐ 3☐ 4☐

Parent/Guardian Contact Information

Mother/Guardian: ______Father/Guardian: ______

Mailing Address: ______Mailing Address: ______

City/State/Zip: ______City/State/Zip: ______

Location of physical address: ______

______

Primary Phone: ______Primary Phone: ______

Alternate Phone: ______Alternate Phone: ______

Email Address: ______Email Address: ______

STEPS FOR OUR LOTTERY PROCESS AT DREAM DINE’

  1. The Lottery Enrollment Period is from February 2017 through April 18, 2017.
  2. During this period parents/guardians must fill out the one-page application.
  3. A receipt number will be given to parents/guardians within a week of the application being turned in.
  4. Receipt numbers will be separated into hats—one for Kindergarten, one for Grade 1, one for Grade 2, one for Grade 3, one for Grade 4.
  5. All receipt numbers will be entered into a random drawing at a public meeting to be announced.
  6. Receipt numbers will be drawn randomly, by grade level, in a blind drawing. The order in which your receipt number is drawn determines your standing on the enrollment list for the respective grade level. For example, if your receipt number is the first to be drawn you become “number one” on the list. All open seats will be filled by the order on the list. When an opening occurs, we call the next person on the list.
  7. Parents can call us to find out where their standing is if they were not able to attend the drawing. Parents will be notified if the student’s number is drawn. When we notify parents, we will confirm enrollment by requesting that parents come by to complete a Registration Packet.
  8. The Registration Packet will ask for information that is required for enrollment and will prepare us to best serve each student (e.g., demographics, former school records release, student strengths, skills and interests, free and reduced lunch application, immunization records, etc.). Once the Registration Packet is complete, this will finalize the enrollment process and secure the student a seat at Dream Dine’.
  9. Parents will be given a deadline to complete the Registration Packet before we will conclude that the family has declined enrollment. Parents are asked to pay close attention to the deadline or to directly communicate a decline in enrollment, as this will open a seat to another student on the list.
  10. If there are still seats available after the April lottery, then a monthly lottery will be held for any remaining spaces until all spaces are filled.
  11. If you have any questions, please feel free to call Dream Dine’ Charter School at 505-368-2500, or you may email .