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7f23/2015 aspiraillinois.schoolwires.net/siteldefaullaspx?pagetype=3&domainld=8&modulelnstanceld=177&viewld=047e6be3-6d87-4130-8424-d8e4e9ed6c2a&renderloc=o&flexdatald=40&pageld=9 ~?RA... c. 7~1LLNOS L<adcrshfp Through Eduoation! Join Our E Mail List 1'+ 11 D Schools Like Us! School nquiry Form Adm isswns ASPRA Hauga11 Middle School ASP RA Antonia Pantoja ASPRh Busi1 1ess and Finance /\SPRA Early College Resources Return to Headlines Now Enrolling Students for the 2015-16 School Year! ASPiRA Commurnry Cnarter Scnoois i-mmepage There is still time to enroll at any of our schools for the 2015-16 school year! f you are interested in learning more about our schools, please fill out our school inquiry form, select the school you are interested in learning more about, and a member of our recruitment team will reach out to you. Remember - Classes begin August 26, 20151 Todavia hay tiempo para inscribirse en cualquiera de nuestras escuelas para el aiio escolar 2015-16. Si deseas aprender mas acerca de nuestras escuelas, por favor lene nuestro formulario de consulta, seleccione la escuela, y un miembro de nuestro equipo de reclutamiento llegara a usted. Recuerde: Las clases comienzan el 26 de agosto de 20151 Get n Touch 2415 N. Milwaukee Ave. Phone: 773-252-0970 Questions or Feedbacl<? i Schoolwires Privacy Policy (Updated)! Tenns of Use http://aspiraillinois.schoolwires.neusiteldefault.aspx?pagetype=3&domainld=8&modulelnstanceld=177&viewld=047e6be3-6d87-4130-8424-d8e4e9ed6c2a&renderloc=o&flexdatald=40&pageld=9 112

7/23/2015 aspiraillinois.sch:>olwires.net/site/defa.jlt.aspx?pagetype=3&domainld=6&mocl.jlelnstanc:eld=177&viewld=047e6be3-6d87-4130-8424-d8e4e9ed6c2a&renderloc=o&flexdatald=40&pageld=9 Chicago, L 60647 Site Map Copyright 2002-2015 Schoolwires, nc. All rights reserved. \ ~KGC:o'f'wtre5; http://aspiraillinois.scrootwires.net/site/defa.jllaspx?pagetype=3&domainld=b&mcxijlelnstanc:eld=177&viewld=047e6be3-6d87-4130-8424-d8e4e9ed6c2a&renderloc=o&flexdatald=40&pageld=9 2f2

7/23/2015 ASPRA Community Charter Schools ASPRA Community Charter Schools School nterest Form/Forma de lnteres Escolar *Required Please select the ASPRA School you are interested in learning more about: * Por favor, seleccione la escuela que deseas obtener mas informaci6n: 0 ASPRA Haugan Middle School 0 ASPRA Early College High School O ASPRA Antonia Pantoja High School O ASPRA Business and Finance High School Student First Name * Nombre [--==~~-=~===] Middle Name Segundo Nombre,--------------------] Last Name* Apellido r---------~---- ------- ---1 1---------- ----- - ---------_J Address* Direcci6n [ -~-----\ -------------~ City* l https://docs.google.com/forms/d/1dirw586kawub8cxhdcwmst7fbkfglpyjj-pcqbhfqbo/viewform?c=o&w=1 1/3

7/23/2015,- Ciudad --- -- ------- i ASPRA Community Charter Schools State* Esta do i----- - -----------.--- L, ~~---~J Zip Code* C6digo 'ostal --------- i!.! Home Phone Numero de Telefono de Casa 1--- - -- --- ------------1 [ L- - ------ ------------- ------- - -- -.--- Cellular Phone Number Numero de Telefono Celular. l,.. J E-mail Address Correo Electr6nico,---------------.. ---- -- ----- ------ -----1 L........J' Date of Birth (mm/dd/yyyy) * Fecha de Nacimiento (mm/dd/aaaa) [~:=~=~-~~-=-==--~~~_-_] Grade Applying For * Grado de Aplicaci6n 06 07 08 09 0 10 0 11 0 12 O Other: Current School * Escuela corriente ---- -----1!---- J! Does a sibling of the applicant attend and ASPRA school?* https://docs.google.com/forms/d/1dirw586kawub8cxhdcwmst7fbkfglpyjj-pcqbhfqbo/viewform?c=o&w=1 2/3

7/2312015 ASPRA Community Charter Schools (,Tiene el estudiante algun hermano/a que va a una escuela de las escuelas de ASPRA? O Yes/Si 0 No f yes, indicate student name/s: Si la respuesta es sf, indique nombre/s del alumno/s: 1 L j With whom does the applicant currently live? * {,Con quien vive el solicitante? O Mother/Madre O Father/Padre O Both Parents/Los Dos Padres O Guardian/Guarda O Other: Parent/Guardian Name 1 Nombre del Padre/Madre/Guarda 1,-------------------- ------- ---: l J Parent/Guardian Name 2 Nombre del Padre/Madre/Guarda 2 c:_-~~~~~~=~ ~-~~-~~--~~~~=~~--~ J Parent nitials l~~cia_!_es -~1~nale~-- 1 l-- - - --------- --~ ---~--- ~--- -~--~! Today's Date (dd/mm/yy) Fecha de Hoy ~d/mm/aaaa),---- i '---- J Submit Never submit passwords through Google Forms. Powered by This form was created inside of Aspira nc of llinois. Report Abuse - Terms of Service -Additional Terms https://docs.google.com/forms/d/1 Di Rw586kawub8CXHdcWM st7fbkfglpyjj-pcqbh F QbO/viewform?c=o&w= 1 313

Application for Admission School Year: o 2014-2015 o 2015-2016 Please select the ASPRA School you are interested in attending: D ASPRA HAUGAN D ASPRA EARLY COLLEGE DASPRA ANTONA PANTOJA MDDLE SCHOOL HGH SCHOOL HGH SCHOOL 3729 W. Leland Ave. 3986 W. Barry Ave. 3121 N. Pulaski Ave. Chicago, llinois 60625 Chicago, llinois 60647 Chicago, L 60641 (773) 252-0970 Ext. SSS (773) 2S2-0970 Ext. 639 (773) 2S2-0970 Ext. 6230 o ASP RA BUSNESS and FNANCE HGH SCHOOL 2989 N. Milwaukee Ave. Chicago, L 60618 (773) 2S2-0970 Ext. 3SS9 Student nformation Last Name First Name nitial Student D Street Address City State (_) ( ) Home Phone Number Cellular Phone Number E-mail address _/ J Date of Birth Age Grade applying for Current school Zip Code Does a sibling of the applicant attend an ASP RA Charter School? D No DYes f Yes, indicate Student's Name--------------- ASPRA School ------- Parent/Guardian nformation: With whom does the applicant currently live? Mother Father Both Parents Guardian Parent/Guardian Name---------------- Same address, phone number and/or email address? Yes No. f No, please complete: Address City State Zip Code Phone Number Email Address----------------- Parent/ Guardian Signature Rev07/14. J ~ ----" ;.. Date Phone(773)252-0970 2415 N. Milwaukee Avenue, Chicago L 60647 www.aspirail.org