Liberty Common School Online Lottery Form

Fill out completely for each student and use the submit button at the bottom to send the completed form to Liberty Common School. Only a one time submittal per student is necessary.

Today's Date:

Student #1:
Date of Birth (month/day/year):
Gender:   Current Grade:   Current School Year:

Interested in attending Liberty for grade:   School Year:

Most Recent School Attended:

Student #2:
Date of Birth (month/day/year):
Gender:   Current Grade:   Current School Year:

Interested in attending Liberty for grade:   School Year:

Most Recent School Attended:

Student #3:
Date of Birth (month/day/year):
Gender:   Current Grade:   Current School Year:

Interested in attending Liberty for grade:   School Year:

Most Recent School Attended:

Student #4:
Date of Birth (month/day/year):
Gender:   Current Grade:   Current School Year:

Interested in attending Liberty for grade:   School Year:

Most Recent School Attended:

* Required field

*Home Address:
*City:
*Zip Code:
*Home Phone Number:
*E-mail address:

Parent(s)' or Guardian's Name(s):

Father's Cell Phone:
Mother's Cell Phone:

Interested in attending Liberty Common High School?   Yes     No

If you are submitting a student for Kindergarten level, please choose an enrollment option.
 All day only ($300 tuition per month ^*)  
 Half Day Only  
 Either half day or all day  

 ^* Tuition subject to change.

By submitting this form I understand that my child/ren's name(s) are being placed in a Lottery Pool for Liberty Common, and that I will be contacted if an opening is available. My name will remain on the list unless otherwise requested. It is my responsibility to contact the school with any phone or address changes.