Re-enrollment Form

This form is for students currently enrolled at MLKECA that will be returning next school year (2022-23).

Student Information

Student First Name

Student Middle Name

Student Last Name

Current Teacher

Grade Next School Year

Parent/Guardian Name

Parent/Guardian Contact (Cell/Home)

Parent/Guardian Email

Home Address Line 1

Home Address Line 2

City

State

Zip

Enrollment Information

Yes, my child will be returning to MLKECA for Fall 2022-2023 School Year.

I will need Latch-key services for 2022-2023 School Year? (required) Yes No

My child will be attending the six-week summer school program (June 28 - July 28) (required) Yes No

My child will be participating in Summer Camp 7 am-6 pm (June 20-August 26, 6 or 10 weeks) (required) Yes No

No, my child will not be returning for the 2022-2023 School year.

Reason

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