Mid-Year Registration Grades 1-6

Spark Charter School

Mid-Year Registration Grades 1-6

Do you wish to accept your offer to enroll this student? *

Yes No

Parent Name *

First

Last

Parent Email *

STUDENT INFORMATION

Student's Name

First *

Middle *

Last *

Spark will transfer all basic data from your application for this student.
Please provide the additional enrollment information below

Last School Attended *

City *

District *

Does this student have any serious allergies? *

Yes No

If yes, please list *

Does student require any medications, such as an Epipen, to be kept in the school office? *

Yes No

HEALTH CARE PROVIDERS

Primary Care Physician

Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Insurance Provider *

Insurance ID # *

Dentist

Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

EMERGENCY CONTACT #1
(Other than parents)

Name *

First

Last

Relationship to student *

Home Phone *

Cell Phone *

Work Phone *

Email *

EMERGENCY CONTACT #2
(Other than parents)

Name *

First

Last

Relationship to student *

Home Phone *

Cell Phone *

Work Phone *

Email *

IMPORTANT: In order to complete the registration process, you must bring a copy of the following to the Spark office. We are located at 739 Morse Ave., Sunnyvale near the preschool at the south end of the campus.

Copy of birth certificate or passport for the student
Proof of current immunizations (click here for requirements)
For students NOT enrolled in Sunnyvale School District during for 2014-15 (i.e. new Sunnyvale residents, students previously enrolled in private school):

Proofs of residency
a. Parent's CA driver's licence, consulate ID, or passport
b. One of the following: Rental agreement, lease, monthly mortgage payment, or property tax bill showing name and address
c. One of the following: PG&E, water, cable, or phone bill showing name and address (dated within 45 days)
d. One of the following: Car registration, payroll document, tax document, or bank statement showing name and address.

4. Signed release to transfer student records Click here for form

Due from parents before the start of volunteering:

Picture ID
Proof of fingerprint / background check.
Proof of negative TB test (valid for 4 years) or TB risk assessment form from doctor
Proof of adequate auto insurance for each anticipated field trip driver (minimum $100,000 per occurrence)