700 Central Avenue ▪ Chester, PA 19013 ▪ 610-499-9030
Information provided in this application, interview and entrance exam is private and will be used only to determine eligibility for FDCS. However, completion of this application does not guarantee acceptance. Incomplete applications will not be considered. Please answer all of the questions completely or mark “N/A” and submit the following items along with this form. 1) Registration fee $100 cash, non-refundable, except ELRC; 2) Child’s birth certificate and SS card; 3) Immunization records and last physical examination; 4) Copy of Insurance Card; 5) Report card and standardized test results, if available; 6) IRS 1040/Official AFDC/Social Security Letter; 7) Expenses: mortgage/lease/rent, utilities (gas & electric, oil, phone, cell, internet, waste removal), food, car note, fuel, auto insurance, medical insurance, daycare/tuition from other schools.
Grade Entering in the Fall
Who has primary custody of child?
Address (If Different From Above)
(Complete Transportation Enrollment Form)