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KIPP Infinity Elementary School 2010-11 Student Application
Lottery Entry Deadline: Applications must be postmarked by April 8, 2010 @ 5pm Lottery Date: April 13, 2010 @ 5:30pm at KIPP Infinity Elementary Notification Letters: Mailed on April 16, 2010

KIPP Infinity Elementary School is a free charter school dedicated to providing students in grades Kindergarten with the academic and character skills necessary to succeed in the nation’s top colleges and beyond. Children who are five years old before December rd 31, 2010 are eligible to enroll for the 2010-2011 school year. The school will be located at 625 West 133 Street. Please note that ALL students are welcome to enter the lottery, regardless of test scores, behavioral history, or academic performance. Attendance at the lottery is not required and will not affect your child’s chances of entering the school. Students who are selected will be contacted by phone to enroll. Admission preference will be given in the following order: 1) 2) 3) 4) 5) Brothers/Sisters of current KIPP Infinity students Applicants Eligible for Free or Reduced Lunch and Residing in NYC School Districts 5 Applicants Eligible for Free or Reduced Lunch and Not Residing in NYC School District 5 Applicants Not Eligible for Free or Reduced Lunch and Residing in NYC School District 5 Applicants Not Eligible for Free or Reduced Lunch and Not Residing in NYC School District 5

On the back of this form, applicants are strongly encouraged to submit documentation supporting their free and reduced lunch eligibility. Completing the back form is strictly voluntary, and all information provided will be used for internal purposes only. For more information about your community school district, please visit: http://gis.nyc.gov/dcp/at/f1.jsp. If you are interested in having your child enter into KIPP Infinity Elementary School for the 2010-2011 school year, you must fill out the information below and submit it to KIPP Infinity in person or by mail by April 8, 2010.

Student Name What grade is your child in currently? What school does your child attend? Student Date of Birth (M/D/Y) Parent/Guardian Name Address (include Apt. #) City, ZIP Phone Number E-mail Name and Grade of Current KIPP brother/sister (if applicable) Name and Current Grade of Brother/Sister in Another 2010-2011 KIPP Lottery (if applicable) How Did You Hear About Us?

(Home)

(Cell)

(Name) (Name) (School)

(Grade) (Grade)

By signing and dating the application below, I am hereby certifying that all information provided is accurate and current. I understand that all information will be verified and enrollment is subject to confirmation of accuracy of the information provided. ______________________________ Signature ___________________________________ Date You can return this form by mail or in person to: Stephanie Adams and Lindsay Fry rd 625 W 133 . New York, NY 10027

All received applications will be confirmed through the mail. If you do not receive written confirmation before the lottery, please contact Ms. Fry (917-547-8674 ) lfry@kippnyc.org or Ms. Adams (917-547-8725) sadams@kippnyc.org .

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