Heartland Charter School 2026–2027 Enrollment Intake Form

Heartland Charter School 2026–2027 Enrollment Intake Form

Heartland Charter School 2026–2027 Enrollment Intake Form

You will need to add all potential students to this form. No required documents are needed at this time. Please read the important information below.

Please review this important information:
- Enrollment is available for TK–9th grade only.
- We do not have availbility in the following areas
  - Los Angeles County
  - Ventura County
  - San Bernardino County except the following:
    
    Adelanto 92301
    
    Barstow 92311
    
    Red Mountain 93558
    
    Trona 93562
- Completing this intake form does not guarantee enrollment. To secure your spot, you will need to complete an application which will be sent to you at a later date via email.
- This is for new families only. Please do not complete this form if you are a current Heartland family.
- To prepare you for the application, feel free to browse through this helpful checklist.
This is our busy season, so please expect a delay in communication.

We look foward to serving you!

Parent/Guardian Name:*

First NameLast Name
Email:*
example@example.com
Physical Street Address:*
City:*
If your city is not listed, please choose OTHER (The city must still be listed in our open areas)
State:*
Zip Code:*
County:*

Please include ALL student's you intend to enroll.
1. Student Name:*

First NameLast Name
Incoming Grade-Level:*
Do you have any other student's you intend to enroll?*

YesNo

Student Name:*

First NameLast Name
Incoming Grade-Level:*
Do you have any other student's you intend to enroll?*

YesNo

Student Name:*

First NameLast Name
Incoming Grade-Level:*
Do you have any other student's you intend to enroll?*

YesNo

Student Name:*

First NameLast Name
Incoming Grade-Level:*
Do you have any other student's you intend to enroll?*

YesNo

Student Name:*

First NameLast Name
Incoming Grade-Level:*
Do you have any other student's you intend to enroll?*

YesNo

Student Name:*

First NameLast Name
Incoming Grade-Level:*
Do you have any other student's you intend to enroll?*

YesNo

Student Name:*

First NameLast Name
Incoming Grade-Level:*
Do you have any other student's you intend to enroll?*

YesNo

By singing this form, I understand that all information listed above is accurate.*

Clear
Should be Empty: