Application - Discovery Charter Preparatory School

2018-2019 School Year Lottery Application

Name of Student*

First

Last

Gender:*

Male

Female

Grade Applying To:*

Freshman (9)

Sophomore (10)

Junior (11)

Senior (12)

Student DOB:*

day

/

month

/

year

Name of Parent (1)*

First

Last

Parent (1) Phone:*

Name of Parent (2)*

First

Last

Parent (2) Phone:*

Address*

Street Address

Primary Contact Email:*

Phone: (818) 897-1187

Fax: (818) 897-1295

Email: info@discoveryprep.org

Address: 13570 Eldridge Ave Sylmar, CA, 91342