Westlake Charter School School Application Grades K 8

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3800 Del Paso Road 1985 Pebblewood Drive Sacramento, CA 95834 Sacramento, CA 95833 Phone 916 567 5760 Phone: 916 928 3987 Westlake Charter School 2016 17 School Application Grades K 8 Westlake Charter School Enrollment Application Process Please note: State law requires incoming Kindergarten students to be 5 years old on or before September 1, 2016 Description of the Program Westlake Charter School is a parent participation program, which prepares students with the skills necessary for life long learning by providing a physically and emotionally safe learning environment that supports academic risk taking, invites student participation, and structures cooperative learning experiences. Our unique and innovative program offers students a well rounded, balanced educational experience that includes foreign language acquisition, a focus on the arts, and an understanding and appreciation of diversity. Westlake Charter s thematic curriculum is integrated into all areas of our program, which helps build competencies necessary to be a productive member of our global community. We encourage all applicants to review our approved charter, posted on our website at www.westlakecharter.com, prior to submitting an application. Statement of Non Discrimination WCS will not discriminate on the basis of race, ethnicity, gender, national origin, religion, disability, or any other class protected by state or federal law or local ordinance in the administration of its programs, admissions policies, and all other operations. Tuition Fee The Charter School is a tuition free public school. Non Sectarian The Charter School is non sectarian in its programs, admission policies, employment practices, and all other operations. Enrollment in Other District Schools No student shall have any right to enrollment in another school or program of the Natomas Unified School District by virtue of their enrollment in the Charter School. Open Application Period Applications will be accepted beginning Tuesday, December 1, 2015 and must be completed and returned in person (please see times and locations below) to either WCS office by 3:00 P.M. on Friday January 29, 2016. No late applications will be accepted. Please note that each child is to have one application on file by the due date and time. Multiple births (e.g. twins) must each have their own application and each will be handled separately like any other sibling. You must deliver your application to one of the folliwng WCS offices: Mon Fri 9:00 am 2:00 pm at Westlake Charter School, 3800 Del Paso Road Mon Fri 8:00 am 2:00 pm and 3:30 pm 5:30 pm at Westlake Charter Middle School, 1985 Pebblewood Drive Enrollment Packet Enrollment packets will be available immediately following the Public Random Drawing on Monday, March 7, 2016 The enrollment packet requests further information about the student and documentation of information provided in this application (i.e. birth certificate, immunizations, medical information). The Enrollment packet MUST be completed and returned to the WCS office with all required documentation by 3:00 P.M. on Friday, April 29, 2016 in order to secure the student s enrollment in WCS. Enrollment will be forfeited if the completed packet is not received by the deadline. There will be no exceptions to this deadline. Public Random Drawing The Charter School shall admit all pupils who wish to attend the school subject to its capacity. If the number of pupils who wish to attend the school exceeds the school s capacity at any grade level, enrollment shall be determined by public random drawing in accordance with the enrollment preferences discussed on page 2 of this application packet. The Public Random Drawing will be held Monday, March 7, 2016 at 5:30 p.m. at Westlake Charter School, 3800 Del Paso Road. The public is welcome to attend; your presence is not required. Please make alternative arrangements for your children, there is no childcare available. For WCS use only

Important dates and FAQ Q. What information is required for the lottery application? A. To apply for the lottery no information is required other than a completed lottery application. Q. Can I mail, email or fax my lottery application in? A. No we require all applications to be returned in person so that we may give you the lottery number for your student. This lottery number also serves as your confirmation. Q. Can I take a tour of the campus? A. We have an open campus observation day on January 21, 2016 for our Del Paso campus. There are 2 tour times available 9:00 am and 12:00 pm. Each guided tour takes approximately 1 hour. No appointment is necessary. Please make arrangements for childcare for your children this is a parent only visitation. We have a middle school info night on January 21, 2016 at 5:30 at our Pebblewood campus. Q. What is the age requirement for enrollment for kindergarten? A. State law requires that incoming kindergarten students are 5 years of age on or before September 1, 2016. For students who miss the deadline by 30 days or less a request for early entrance appeal is available at the office. Please complete the application and request the appeal paperwork when you turn it in. We will not accept any lottery applications for students who don t meet that state requirement within the 30 day window. Q. When is the lottery? A. The lottery is scheduled for 5:30 pm on March 7, 2016. The lottery will be held at 3800 Del Paso Road, Sacramento, CA 95834. The lottery is open to the public however children are not allowed. You do not need to be present. Q. If we are not able to attend the lottery how do we find out if our number is chosen? A. Lottery results will be posted on Friday, March 11. 2016. We will post the results on our website and also at both campuses. We will not give results over the phone. Q. How many openings will you have in the lottery? A. The only known openings will be 110 in kindergarten, 2 openings in 4 th grade, 1 opening in 7th grade, and 5 openings in 8th grade. These figures can change between February 1 st and March 7 th. If that happens we will announce it at the lottery. For all other classes we will draw numbers for the 2016-17 wait lists. Should an opening become available we will contact families in order of the wait list number. Each family is given 24 hours to accept enrollment before we move to the next family on the wait list. Q. Can I put my child on the wait list? A. Once our lottery is complete and wait lists are generated we can add students to the wait list in order that the request(s) are received. Q. Can I volunteer or make a financial donation to the school to increase my student s chances in the lottery? A. You are always welcome to volunteer at Westlake Charter School and to participate in any community or fundraising event however it is illegal for us to accept volunteer time or financial contributions in exchange for lottery preference.

STUDENT WILL BE ENTERING GRADE Student s legal name as printed on birth certificate: K 1 2 3 4 5 6 7 8 FOR THE 2016 17 SCHOOL YEAR PLEASE CIRCLE ONE Last First Middle Birth Date Address where student resides: Street Apt # City Zip Code MULTIPLE STUDENTS FROM SAME HOUSEHOLD If there is another student who resides in the same home and is in the same grade level as the applicant, who is also filing an Enrollment Application to Westlake Charter School (e.g. twins), please write the name(s) here: ENROLLMENT PREFERENCES SURVEY Currently enrolled students who will be moving up into the next grade level will be automatically re enrolled. Preferences in the public random drawing shall be extended as provided for by law and in the approved charter as follows: 1. Children of Founders² 2. Children in a family, who meet the federal school guidelines for economic support known as Title One or Free or Reduced Lunch subsidy AND the parents or chief guardians are NOT graduates of a four year college or university (this preference shall apply to a maximum of 20% of total grade level enrollment.) 3. Siblings of currently enrolled students 4. Children of Westlake Charter School employees/children or grandchildren of WCS board of director members 5. District residents 6. Students from the prior year wait list Does your student qualify for any of the above preferences in the public random drawing? PLEASE CHECK YES OR NO FOR EACH CATEGORY: 1. Child of Founding Parent ² (see footnote for explanation): YES NO 2. Mom graduated from a four year college or university YES NO 3. Dad graduated from a four year college or university YES NO 4. Family qualifies under income guidelines for Free and Reduced Lunch Subsidy according to the attached chart (p.4): YES NO 5. Siblings of students who are currently enrolled in WCS: YES NO 6. Children of Westlake Charter School employees: YES NO 7. Natomas Unified School District (NUSD) Residents: YES NO Current school 8. Students from the 2015 16 WCS wait list: YES NO ² For purposes of this Preference, Founders is defined as any family who donated at least 50 hours of volunteer time to the creation of the charter prior to June 15, 2005. There is no Founder status for Westlake Charter Middle School. For WCS use only

Westlake Charter School 2016 17 School Application Grades K 8 WCS Family Commitment: Please be aware that if your child is enrolled in Westlake Charter School, each family commits to volunteering thirty hours per year to help support the school. If your child is admitted to WCS for the 2016 17 school year, you will receive a comprehensive list of volunteer opportunities available for earning hours. In addition, you will be required to sign a Parent/Student Handbook and Behavior Acknowledgement which will describe in more detail Westlake Charter School s expectations of students, parents, and the school. I have read, understand and agree with the family commitment expectations. (initial) WCS Uniform Policy/Dress Code: WCS strictly enforces its uniform policy and dress code. Any free dress days will be clearly noted on the school calendar. If a child comes to school dressed out of compliance with the uniform policy or dress code, their parent will be notified. For a full list of WCS approved uniform apparel, please visit the Westlake Charter School website ( www.westlakecharter.com ). I have read, understand and agree with the WCS Uniform Policy/Dress Code expectations. (initial) Enrollment Packet The enrollment packet MUST be completed and returned to the WCS office with all required documentation by 3:00 P.M. on Friday, April 29, 2016 in order to secure the student s enrollment in WCS. Enrollment will be forfeited if the enrollment packet is not received by the deadline. There will be no exceptions to this deadline. I have read and understand the enrollment packet deadline information as stated above. (initial) Contact List Should WCS not be able to offer enrollment to my student, I am interested in hearing from other high quality charter schools in the area. I agree to the sharing of my contact information (initial) By signing below, I agree that all of the information provided above is accurate and truthful to the best of my knowledge and belief. Signed under penalty of perjury under the laws of the State of California. By signing, I understand that if any of the information contained herein is determined to be false, this application will be considered void. PARENT/GUARDIAN INFORMATION: (Please list in order of contact priority) 1. Parent/Guardian Name Email Address Home Phone Cell Phone 2. Parent/Guardian Name Email Address Home Phone Cell Phone Parent/Guardian Signature Parent/Guardian Signature Date Date

Income Eligibility Guidelines for Free and Reduced Price Meals or Free Milk in Child Nutrition Programs Effective July 1, 2007 through June 30, 2008, participants from households with incomes at or below the following levels ma be eligible for free or reduced price meals or free milk. Note: The new income calculations are based on annual figures and the following formulas: Monthly = annual income divided by 12; Twice Per Month = annual income divided by 24; Every Two Weeks = annual income divided by 26; and Weekly = annual income divided by 52. All dollar amounts are rounded up to the next whole dollar. FREE ELIGIBILITY SCALE MEALS, SNACKS, AND MILK Household Size Annual Monthly Twice Per Month Every Two Weeks Weekly 1 $13,273 $1,107 $554 $511 $256 2 $17,797 $1,484 $742 $685 $343 3 $22,321 $1,861 $931 $859 $430 4 $26,845 $2,238 $1,119 $1,033 $517 5 $31,369 $2,615 $1,308 $1,207 $604 6 $35,893 $2,992 $1,496 $1,381 $691 7 $40,417 $3,369 $1,685 $1,555 $778 8 $44,941 $3,746 $1,873 $1,729 $865 For each additional family member, add: + $4,524 + $377 + $189 + $174 + $87 REDUCED PRICE ELIGIBILITY SCALE MEALS AND SNACKS Household Size Annual Monthly Twice Per Month Every Two Weeks Weekly 1 $18,889 $1,575 $788 $727 $364 2 $25,327 $2,111 $1,056 $975 $488 3 $31,765 $2,648 $1,324 $1,222 $611 4 $38,203 $3,184 $1,592 $1,470 $735 5 $44,641 $3,721 $1,861 $1,717 $859 6 $51,079 $4,257 $2,129 $1,965 $983 7 $57,517 $4,794 $2,397 $2,213 $1,107 8 $63,955 $5,330 $2,665 $2,460 $1,230 For each additional family member, add: + $6,438 + $537 + $269 +$248 + $124 A household of one means a child who is his or her sole support. Foster children are one member households only if the welfare or the placement agency maintains legal responsibility for the child. Household is synonymous with family and means a group of related or unrelated individuals who are not residents of an institution of boarding house, but who are living as one economic unit sharing housing and all significant income and expenses. This scale does not apply to households that receive Food Stamps, Kin Gap, Or FDPIR benefits or children who are recipients of CALWORKS. Those children are automatically eligible for free meal benefits. In the Adult Care Component of the Child and Adult Care Food Program, a household includes the adult participant and, if residing with the participant, the spouse, and any persons who are economically dependent on the adult participant. This scale does not apply to members of Food Stamp households, or recipients of Supplemental Security Income, Medicaid/Medi Cal, or Food Distribution Program On Indian Reservations benefits. Those participants are automatically eligible for free meals.