Request for Placement on the Palm Desert Charter Middle School Waiting List Application Deadline is April 6, 2018 for the 2018/2019 School Year
To validate the Request for Placement, a signed and dated application MUST be hand delivered to: Palm Desert Charter Middle School, 74200 Rutledge Way, Palm Desert, CA 92260 Date
Student Last Name
Student First Name
Birth Date
Gender
Middle
Office Use Only Date Rec’d:____________ Time _________________ Staff Initials____________
Parent Name
Street Address
City, State
Zip
Mailing Address (if different than above)
City, State
Zip
Contact Phone Number
Current Grade
Email Address
Grade Applying For
Current School
Sibling Information Name and grade of children already attending PDCMS: Name Grade 1. 2. Name, grade and school of other children attending DSUSD: Name Grade School 1. 2. 3.
Is your child on an IEP (Special Education)?
Program type? (circle one)
Home School (if different from Current School)
RSP
Autism
Speech
SDC/LH
SDC/ED
SDC/SH
Middle School of Residence
Additional Information (Please mark all that apply) ___PDCMS Preference Zone ___Sibling of current PDCMS student ___Child of PDCMS or WCS Staff member ___WCS/Lincoln ES/Carter ES student on an Intra/Inter District transfer ___DSUSD Resident ___Out of DSUSD Boundary_____________________________ (list district of attendance)
Ethnicity (Please mark all that apply) Required for federal reporting purposes ___African American ___Asian/Pacific Islander ___Caucasian ___Native American ___Hispanic ___Other____________________________
I am applying for placement of my child on the waiting list for Palm Desert Charter Middle School. All information has been presented accurately. I will notify the school personnel should any residency information change. Inaccurate information will invalidate this application. For further information call the PDCMS office at 760 862-4320 and/or visit the PDCMS Web site: www.dsusd.us/schools/pdcms
Parent/Guardian Signature
Date of Application
Solicitud para Colocación en la Lista de Espera para Palm Desert Charter Middle School Fecha Limite es el 6 de abril del 2018 para el año escolar 2018/2019
Para que su petición sea valida, una solicitud con firma y fecha tiene que ser entregada a: Palm Desert Charter Middle School, 74200 Rutledge Way, Palm Desert, CA 92260 Fecha
Apellido del Estudiante
Fecha de Nacimiento
Primer Nombre del Estudiante
Género
Segundo
Solo Para Uso de Oficina Fecha de entrega:_______ Hora _________________ Iniciales de empleado____
Nombre del Padre
Dirección
Ciudad, Estado
Codigo Postal
Dirección de Envio Postal (si es diferente de arriba)
Ciudad, Estado
Codigo Postal
Teléfono
Esta su hijo/a en IEP (Educación Especial)?
Email
Tipo de programa? RSP
Autism Speech
SDC/LH SDC/ED
Grado Actual
Grado para el que se esta Aplicando
Escuela Actual
Información de Otros Hermanos Nombre y grado de niños ya asistiendo PDCMS: Nombre Grado 1. 2.
Nombre, grado y escuela de otros niño/as asistiendo DSUSD: Nombre Grado Escuela 1. 2. 3.
Escuela Actual de Residencia
SDC/SH
Escuela intermedia de Residencia
Información Adiciónal (Favor de marcar todo lo que aplique) ___Zona de preferencia a PDCMS ___Hermano/a de un estudiante actual de PDCMS ___Hijo/a de un empleado de PDCMS/WCS ___Estudiante de Primaria WC/Lincoln/Carter con transferencia Dentro/Fuera del Distrito ___Residente de DSUSD ___Fuera de las fronteras de DSUSD ______________ (ponga el distrito de asistencia) Etnica (Favor de marcar todo lo que aplique)
Requerida para propósitos de reportes federales ___Africano Americano ___Asiano/Pacifico Isleño ___Caucáseo ___Nativo Americano ___Hispano ___Otro____________________________
Solicito la colocación de mi niño/a en la lista de espera para Palm Desert Charter Middle School . Toda la información se ha presentado con exactitud. Notificaré al personal de la escuela si ubiese cualquier cambio de información de residencia. Información inexacta invalidará esta solicitud. Para información adicional llame a la oficina de PDCMS y/o vea el website de PDCMS. www.dsusd.us/schools/pdcms
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Page 1 of 3. KHWOPA COLLEGE OF ENGINEERING. Result of Entrance 2074. ELECTRICAL SECOND WAITING MERIT LIST. 1 of 3. Remote. S.N. ID IOE Roll No. IOE. Rank PR Name of Student Gender Permanent Address District IOE Score. 1 5456 2074-8962 4570 2 Santosh
Page 1 of 4. KHWOPA COLLEGE OF ENGINEERING. Result of Entrance 2074. CIVIL FIRST WAITING MERIT LIST. 1 of 4. Bhaktapur Municipality. S.N. ID IOE Roll No. IOE. Rank PR Name of Student Gender Permanent Address District IOE Score. 1 5309 2074-1289 3770
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Do you currently have a child/children attending Compass Public Charter School? No Yes. I understand that any false or incorrect information on this application ...
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