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Woodlake Elementary Community Charter

23231 Hatteras Street
Woodland Hills, Ca 91367
(818)347-7097
Charter Lottery Application for 2018-2019
Student Information (please print)
Last Name: _ _ _ _ _ _ _ _ _ _ _ __ First Name: _ _ _ _ _ _ _ _ _ _ _ _ MI: _ __
Address:
Date of Birth: _ _ _ _ __ Gender: Male __Female
Current Grade in school: Grade entering in August 2018_ _ __
Current school of attendance: _ _ _ _ _ __ Do you live in LAUSD's boundaries? _ _ _ _ __
Do you have a child already attending Woodlake Elementary Community Charter? (Yes/No) ___ Current grade? _ __
Parent/Guardian Contact Information
Parent/Guardian #1:._ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Relationship: _ _ _ _ _ _ __
Phone#: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Email:._ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Parent/Guardian #2: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Relationship:._ _ _ _ _ _ __
Phone#: Email:_ _ _ _ _ _ _ _ _- ' - - - - - - - - - - -
Signature: ______________________ Date:
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NOTE: No Transportation is provided with the Afftliated Charter permit. Siblings are not guaranteed.
Lottery Application Deadline is April 20, 2018 at 4:00 pm
The random public drawing will be held on April 27, 2018 at I 0:30 am
*Please deliver the Lottery Application to the main office between the hours of 7:30am-4:00pm, Monday-Friday. No faxes
will be accepted.
*The number of seats available in each grade level may not be determined until after the start of the school year. Once the
number of seats is determined, enrollment offers will be made. Not every grade level will have available seats. Siblings of
current pupils must fiII out a lottery application and go through the lottery process.
Upon acceptance, an original birth certificate, proof ofresidence and immunization records must be providedfor
verification. froof offamily relationship may also be required for verification. Woodlake Elementary Community Charter
does not discriminate against any student on the basis of disability, gender, nationality, race or ethnicity, religion, sexual
orientation, or any other characteristic that is contained in the definition of hate crimes set forth in Section 422.55 of the
Penal Code.
Your child's random public drawing lottery ID number is _ _ _. This number will be used during the random
public lottery instead of your child's name. After the drawing, your child's waitlist position will be posted on
www.woodlakeelementary.org using this ID number, instead of your child's name.
Signature of Parent/Guardian acknowledging that you have read the information: _ _ _ _ _ _ _ __