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Application Form

***Discovery only accept students residing in Newark***

Please complete the form below. Required fields marked *

Student's Name (First, Middle, Last) :*

Answer Required

Birth Date:*

Answer Required

Birth City*

Answer Required

Birth Country*

Answer Required

Sex*

Answer Required

Female

Male

Other

Name of Child's Current School:*

Answer Required

Parent (s) / Guardian (s):*

Answer Required

Home Address:*

Answer Required

Newark, New Jersey - Zip Code:*

Answer Required

Cell Phone*

Number Required

Email Address:*

Answer Required

Work Phone

Number Required

Home Phone

Number Required

If your child has siblings currently attending Discovery Charter School, list them below:

Answer Required

Confirmation Email

Email Required