2020-2021 Application for Admittance to Durham Nativity School (English) Please complete the form below to apply for admittance to Durham Nativity School. Thank you. Durham Nativity School provides an enriched learning environment and a twelve‑year support system for middle school boys who have the ability and commitment to achieve, but not the resources for a quality, independent school education. We promote a rigorous academic program and nurture the whole child to reach his potential through knowledge, moral values, learning skills, discipline, and character development. We instill service for others as we build tomorrow’s role models and community leaders.Student's Name* First Last Your Son's Birthday:*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Your Son's Current Grade Level*3rd Grade4th Grade5th Grade6th GradeYour Son's Current School*Applying for admittance to...5th Grade6th GradeParent Name* First Last Parent Name First Last Parent Phone Number*Parent Email* Enter Email Confirm Email Parent Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Does your son currently receive free or reduced lunch?*YesNoPrimary language spoken at home*EnglishSpanishDoes your son currently have an IEP (individualized education plan) or receive additional assistance?*YesNoNot that I'm aware ofCan you provide transportation for your son to and from Durham Nativity School in downtown Durham?YesNo, I need transportation to be provided.Do you require an after-school program for your son?YesNoNo, but I would be interested in an after school program.Records ReleaseI grant DNS permission to request and receive school records which will include EOG’s, past and current report cards from the school listed on my son's application.*Electronic Signature: Please type your first and last name as you would when signing a document.Today's Date* Date Format: MM slash DD slash YYYY I understand that checking this box constitutes a legal signature confirming that I acknowledge permission.* Yes PhoneThis field is for validation purposes and should be left unchanged.