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Student Application Form

Please complete the student application form below for students entering grades 6 - 9 in the Fall of 2021. Required fields marked *

Parent's First Name*

Answer Required

Parent's Last Name*

Answer Required

Child's First Name*

Answer Required

Child's Last Name*

Answer Required

Child's Date of Birth*

Answer Required

Child's Grade in the Fall of 2021*

Answer Required

Child's Current School

Answer Required

Does your child have an IEP? (IEP students have preference)*

Answer Required

Yes

Does your child have a sibling who attends CAMPA? (Siblings have preference)*

Answer Required

Yes

Home Street Address*

Answer Required

City*

Answer Required

Zip/Postal*

Answer Required

Parent's Email Address*

Answer Required

Parent's Mobile Phone*

Answer Required

Home Phone

Answer Required

Work Phone

Answer Required

If applicable, who referred you to CAMPA Charter Middle School?

Answer Required

Confirmation Email

Confirmation Email *

Enter your email address here if you'd like to receive a confirmation upon submitting the form.

Email Required