Enrollment Form Online

2012-13 and 2013-14 Open Enrollment Application

We are currently enrolling for both the current school year and for next year. You can select both if your student is currently in the 6th grade. You will hear back from us within two weeks of submitting an application. If you have any questions, please email us at info@meritprepschools.org or call Erika at (862) 235-0367.

Enrollment Year *

Current School Year (2012-2013) - students currently in 6th grade

Next School Year (2013-2014) - students currently in 5th or 6th grade

Student Information

Student's First Name *

Student's Middle Name

Student's Last Name *

Gender *

Male

Female

Date of Birth *

Month

Day

Year

Current Grade *

If you are applying for the 2013-2014 school year, what grade are you applying for? *

Race

Please check one (optional). Information about race, gender and ethnicity is collected for statistical purposes required by the State of New Jersey. All New Jersey Charter Schools are committed to serving all students, regardless of race, creed, color, national origin, ancestry, age, marital status, affectional or sexual orientation, gender, religion, academic ability, disability, or socioeconomic status.

Address

Number / Name of Street, Apt # *

City *

State *

Zip Code *

Mailing Address

If your mailing information differs from your street address.

P.O. Box # or Number / Name of Street

City

State

Zip Code

Family Information

Parent

Step-parent

Legal Guardian

Full Name

Home Phone #

Cell Phone #

Work Phone #

E-mail Address

Siblings

Do you want to enroll more than one child at Merit Prep Newark? Please list the siblings name(s) and grade(s) below.

Sibling Name

Grade in 2012-2013

Sibling Name

Grade in 2012-2013

Sibling Name

Grade in 2012-2013