Online Application | Chattahoochee Hills Charter School

Student/Family Inforamtion

Last Name (required)	First Name (required)	Middle Initial
Name the child goes by	Home Phone
Email Address(required)
Home address
City	State	Zip
Birthdate	Sex	Grade for 2011-2012
Social Security #
Student lives with Parents Mother Father Legal Guardian

Previous school(s) attended

Grade(s)

Child of full-time faculty/staff member at Chattahoochee Hills Charter School: Name(s) / Age(s)

Parent/Guardian Information

Parent’s Name: Last	First
Daytime phone	E-mail address
If different from applicant’s: Home address
County of residence
City	State	Zip
Occupation	Employer
City	State	Business phone

Parent’s Name: Last	First
Daytime phone	E-mail address
If different from applicant’s: Home address
County of residence
City	State	Zip
Occupation	Employer
City	State	Business phone

In Case of Emergency

Contact Name #1:

Last Name	First Name	Relationship to student
Phone	Alternate phone(s)

Contact Name #2:

Last Name	First Name	Relationship to student
Phone	Alternate phone(s)

Read and Sign

Parental involvement is key to the success of the Chattahoochee Hills Charter School. Parents and
guardians of attending students must commit to the following volunteer service annually:

Two-parent households with one child in Chattahoochee Hills Charter School will donate
at least 20 hours.
Two-parent households with more than one child in Chattahoochee Hills Charter School
will donate at least 30 hours.
Single-parent households with one child in Chattahoochee Hills Charter School will donate
at least 10 hours.
Single-parent households with more than one child in Chattahoochee Hills Charter School
will donate at least 15 hours.

I understand the volunteer service requirement and agree to complete the required hours annually.
Yes No

I have read and understood this application, and I further certify that the information I have submitted is complete and accurate to the best of my knowledge and belief.
Yes No

Signature of parent/guardian (Please print name)

Security Question