Berks Charter School - Enrollment Form

Fill in ALL fields - submit form

Child's Last Name:

Child's First Name:

Child's Middle Initial:

Entire Home Address & School Distict:




Other List other gender

Name of last school attended:

What grade will your child be entering in 2018?

Areas of Interest:



Musical Theatre

Figure Skating

Vocal Music

Design & Digital Art

Instrumental Music

Other List other Interest

Is your child receiving special services?




If YES explain:

Child lives with:

Both Parents

Both Parents Alternately

Father Only

Mother Only

Other living arrangements

Please list other


Parent/Guardian First Name:

Parent/Guardian Last Name:

Parent/Guardian Home Address:

Phone Number:

Email Address:

How did you hear about us?:

I understand that the Berks Charter High School for the Performing & Visual Arts will service students from Berks & surrounding counties in grades 9-12. I further understand that this school will focus on a variety of visual and performing arts along with a strong academic program. I further understand that this is a preliminary application, non-binding and indicative of my interest and support for this school.

Please Type Signature in Box Below:

Please Enter Today's Date:

YES - signed disclaimer

NO - did not sign disclaimer

Proposed site

Tom at a Berks Open House

School Building Porch

Pre-enroll today

Female Student

Male Student

Tom talking to parents & Students

Pre-Enroll Today!

1504 Hill Road - Reading, PA 19602
Office: 484-264-7302