Application for Enrollment 2019 - 2020

Child's Last Name

Child's First Name

Preferred Name or Nickname

Gender

Date of Birth (mm/dd/yyyy)

Applicant is a:

New Student Returning Student Sibling Legacy

Admission is granted first to priority families and remaining positions are filled with new applications as determined by lottery, if necessary. A waitlist will be established, and applicants notified of their position on that wait list, if necessary.

Questions? Call the school office at 312-944-5469 or email our Membership Chairs at membership@lincolnparkcoop.org

Program Preference One

Program Preference Two

Program Preference Three

Family Information

Parent/Guardian Name (Preferred Contact)

Street Address

City

State

Zip

Preferred Contact Phone

Email Field

Employer/Occupation

Parent/Guardian Name

Street Address (If different than preferred contact)

City

State

Zip

Preferred Contact Phone

Email Field

Employer/Occupation

If Parents/Guardians do not reside together with whom does the child reside?

Primary Contact Parent Other Parent

Are there other children who reside in the home?

Yes No

Sibling Names/Gender/Date of Birth

Participating parents assist in the classroom on a rotating basis. All families serve either on the board of directors or a committee of the board. Non-participating parents pay a higher tuition.

Participating Non-Participating

Would you like to receive information about need based financial aid? (Applications for aid do not affect admissions.)

Yes No

Other:

The following questions are voluntary and do not affect offers of admission. LPCNS is committed to being a diverse and inclusive school community. We encourage applicants with a wide range of experiences and perspectives to apply to our school. Some examples of this kind of diversity include, but are not limited to: race/ethnicity; family makeup; socioeconomic status; religion; and ability. Do you have experiences that would improve our community's diversity and equity? By answering the following questions, you can help us know if our efforts to increase the diversity of our applicant pool are being met.

How do you define the ethnicity of your family?

What languages are spoken in your home?

What is the country of birth for parents and children?

Is there anything else you wish to share about your family? (Background, structure, other ways to identify)

Applications for new students must be received by February 8th, 2019 to be included in our lottery. Admission is granted first to priority families and remaining positions are filled with new applications as determined by lottery, if necessary. A waitlist will be established, and applicants notified of their position on that wait list, if necessary.

Questions? Call the school office at 312-944-5469 or email our Membership Chairs at membership@lincolnparkcoop.org

A non-refundable $50 application fee must be submitted with this form. Please contact admin@lincolnparkcoop.org if you have questions about the fee and financial aid.