WMST PCHS
1920 Bladensburg Rd, N.E.
Washington, DC 20002
202-636-8011
Home of the Panthers

WMST PCHS Application

School Year:
E-Mail:
Check One:	New student Returning Student, if Yes, Enter School Year:
Current School ID No. (If DCPS)

Student's Name:
Last:
First:
Middle:
Date of Birth:
Address:
Home Phone:
City:	State: Zip Code:

Current School (if you are a new student)
School Name:
Address:
Phone:
	Current Grade Level: Grade Level Next Year:

	List any medical or Physical conditions that require special attention:

PARENT INFORMATION
Mother's/Legal Guardian's Name:
Phone:	Home Work Cell/Pager
Address:
Employer:

Father's/Legal Guardian's Name:
Phone:	Home Work Cell/Pager
Address:
Employer:

EMERGENCY CONTACT (Contact persons are granted authority when we are unable to reach a Parent/Guardian)
Name:
Relationship:
Phone:	Home Work Cell/Pager
Address:
	City: State: Zip Code:

Upload Documents (.zip):

PLEASE READ CAREFULLY BEFORE SIGNING Statement of Non-Discrimination and confidentiallity: WMST does no discriminate on the basis of race, sex, color, age, religious affiliations, sexual orientation, income level, physical/mental disabilities, national origin, or ancestry. The contents of this application will remain confidential. Only those individuals with a legitimate business need-to-know will have access to the application and supporting documentation. Information concerning a parent/guardian's employer, salary, or government assistance level is used solely for the purpose of applying for federal funding for the school. Lunch Application WMST requires that all parents of students applying for enrollment complete a Lunch Application when returning the registration packet. It is mandatory that all questions on the application be completed even if your family does not require government assistance or need to apply for free or reduced priced meals. Health Records/Immunization Requirements: Upon enrollment, all students in Public Charter Schools in the District of Columbia must have proof of immunization for: DPT (Diptheria/Pertussin/Tetanus); OPV (Oral Polio Vaccine); MMR (Measles, Mumps, rubella); HIb (Haemophilus Infulenza type b); HepB (hepatitis B); Varicella (If the child has not had Chicken Pox). Proof of Residency (NEW STUDENTS ONLY) A copy of the child's last report card with the most recent grades must accompany the application. The final report card must be submitted prior to admission. Dress Code/Discipline Policy Students and parents must read and agree to the dress code and discipline policy prior to admission. Academic Progress All students entering WMST must maintain a grad point average of at least 2.0. At the end of the 2 nd semester, students who do not have a 2.0 GPA will be placed on academic probation. Tutorial assistance will be provided to assist students with improvement. At the end of the 2 nd semester, if the student's GPA does not improve, he/she is subject to dismissal. Attendance Students' attendance will be monitored daily. At the end of the 1 st semester if a student has excessive absences, he/she will be placed on probation. If at the end of the 2 nd semester his/her attendance does not improve, he/she is subject to dismissal. Binding Arbitration Agreement I/We agree to the use of binding arbitration rather than litigation in the resolution of any and all disputes involving the appropriate education of my child. Parental Agreement I/We give our child permission to attend WMST. I/We agree to take a personal interest in my child's academic success and understand that any of my child's belongings of which he/she is in possession at the school is responsibility of my child.

	I certify that I have read and understand all of the information above and that all of the information submitted is accurate. I understand that providing false information for purposes of defrauding the government is punishable by law and cause for my son's/daughter's dismissal from school.