DEAR PARENT(S) AND APPLICANT:Thank you for your interest in Clarksdale Collegiate. Please complete this form to demonstrate interest in enrolling your child into our school for the 2025-26 school year. Clarksdale Collegiate is a public open enrollment school with limited seats available each year. There is no cost to attend our school. Clarksdale Collegiate offers special education services and transportation within Coahoma County.

Completing this form does not guarantee enrollment. Falsifications, misrepresentations, or omissions may disqualify your application. You will receive detailed communication via email regarding the status of your application after your submission. Thank you again for your interest!

Enter name as it appears on student's birth certificate.

Dear Parent/Guardian:

Mississippi charter schools are required to conduct enrollment lotteries for admission if more students submit applications than there are spots available. Students who are eligible for free lunch or special education services receive a preference in charter school lotteries. With your consent, the Mississippi Charter School Authorizer Board (MCSAB) will request your child’s eligibility for free lunch and/or eligibility for special education services from the Mississippi Department of Education (MDE).

For the MDE to release this information to the MCSAB, we must have your permission. MCSAB will not share the information with any other entity. Failure to sign this consent will not affect the student’s eligibility for the free lunch program or special education services.

When you are finished, please click 'Submit' to complete this form.

We/I, the undersigned, hereby certify that, to the best of our/my knowledge and belief, the answers to the foregoing questions and statements made by us/me in this application are complete and accurate. We/I understand that any false information, omissions, or misrepresentations of facts may result in rejection of this application or future dismissal of the applicant.

Please review this application carefully before submitting.  You will not be able to make changes to the information after you press submit.

NON-DISCRIMINATION STATEMENT: It is the policy of Clarksdale Collegiate Public Charter School to comply with all state and federal regulations regarding admission and not to discriminate during the admission and the lottery process on the basis of gender, national origin, ethnicity, religion, disability, academic, artistic, athletic ability, or the district the child would otherwise attend.