Enrollment Form 2026-2027

Thank you for completing 2026-2027 enrollment materials with Collegium Charter School!

When completing the Enrollment Form below, please note that:

  • Questions with a 'REQUIRED' box after them cannot be left blank. If you don't want to answer a required question or the answer does not apply to you, please enter 'NA'.
  • If you need assistance completing this form, please email our Enrollment Department, and provide a telephone number we can use to contact you.
  • For families who prefer to speak in Spanish, please use the Spanish version of this Enrollment Form. (Para las familias que prefieren hablar en español, por favor utilice la versión en español de este formulario de inscripción.)

Student Information

If applicable.

Choose NO if born in a US Territory.

Home/Housing Information

Your responses to the questions below will help Collegium staff determine if the child is eligible for additional community benefits/services. Your responses will not affect the child's enrollment status.

Academic Information

Preschool information is not applicable.

If you are unsure, please contact the child's current school. If yes, please upload a copy at the end of this form.

If you are unsure, please contact the child's current school. If yes, please upload a copy at the end of this form.

Safe Schools Information

For the following 'Safe School Questions', answer 'FALSE' if the child HAS BEEN SUSPENDED OR EXPELLED for the reasons described. Answer 'TRUE' if NOT.

I attest that I AM the parent/guardian or have legal custody of the child listed above.

The child listed above HAS NOT BEEN SUSPENDED OR EXPELLED from any public, charter, independent, private, or parochial school for an act or offense involving weapons committed on school premises, during a school-sponsored activity, or on any public or private conveyance providing transportation to/from school or a school-sponsored activity.

The child listed above HAS NOT BEEN SUSPENDED OR EXPELLED from any public, charter, independent, private, or parochial school for an act or offense involving alcohol and/or drugs committed on school premises, during a school-sponsored activity, or on any public or private conveyance providing transportation to/from school or a school-sponsored activity.

The child listed above HAS NOT BEEN SUSPENDED OR EXPELLED from any public, charter, independent, private, or parochial school for an act or offense involving the willful infliction of injury to another person committed on school premises, during a school-sponsored activity, or on any public or private conveyance providing transportation to/from school or a school-sponsored activity.

The child listed above HAS NOT BEEN SUSPENDED OR EXPELLED from any public, charter, independent, private, or parochial school for an act or offense involving any act of violence against person(s) and/or property committed on school premises, during a school-sponsored activity, or on any public or private conveyance providing transportation to/from school or a school-sponsored activity.

The child listed above HAS NOT BEEN SUSPENDED OR EXPELLED from any public, charter, independent, private, or parochial school for an act or offense involving 24 P.S. § 13-1318.1 related to students convicted or adjudicated delinquent of sexual assault. I make this statement subject to the penalties of 24 P.S. §13-1318.1(g) and 18 Pa. C.S.A.§4904, relating to unsworn falsification to authorities, and the facts contained herein are true and correct to the best of my knowledge, information, and belief.

Ethnicity and Race Report

This form is to be filled out by the child's parents or guardians, and both questions MUST be answered. Part A asks about the child's ethnicity, and Part B asks about the child's race.

Part A - Ethnicity

The question above is about ethnicity, not race. No matter which answer you selected above, continue and respond to the next question by selecting from one or more of the options below to indicate what you consider this student's race to be.

Part B - Race

  • American Indian or Alaskan Native: A person having origins in any of the original peoples of North and South America including Central America, and who maintains a tribal affiliation or a community attachment.
  • Asian: A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.
  • Black or African American: A person having origins in any of the black racial groups in Africa.
  • Native Hawaiian or other Pacific Islander: A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.
  • White: A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.

Choose one or more:

Home Language Information

Family Information

Contact Information

Please enter in your student's contacts in the order you would like them contacted in case of an emergency.  Important:  Add YOUR contact information, most likely in the Contact 1 or Contact 2 sections.

Contact 1

Genderrequired
Emergency Contactrequired
Has custodyrequired
Can pick up studentrequired
Lives with studentrequired

Contact 1 Contact Information

Preferred phone number?required
Preferred phone number?
Preferred phone number?

Additional Contact

Would you like to add another contact?required

Contact Priority

To adjust the priority in which contacts will be called, please select the appropriate order number next to the name.

Enrollment Questionnaire

Your responses will not, and cannot, impact the child's enrollment at Collegium Charter School.

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Electronic Signature

The electronic signature below and all of its related fields replace a handwritten signature on paper and are legally binding.

I affirm that the information provided is true, correct, and complete, to the best of my knowledge and belief. This electronic signature below and its related fields are treated by the district like a handwritten signature on a paper form.

Parent/Guardian Signature

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