WMST PCHS
1920 Bladensburg Rd, N.E.
Washington, DC 20002
202-636-8011
Home of the Panthers

WMST PCHS Application

School Year:
E-Mail:
Check One:	New student Returning Student, if Yes, Enter School Year:
Current School ID No. (If DCPS)

Student's Name:
Last:
First:
Middle:
Date of Birth:
Address:
City:	State: Zip Code: Ward:
Home Phone:
Student's Email Address:

Current School (if you are a new student)
School Name:
Phone:
	Current Grade Level: Grade Level Next Year:

PARENT INFORMATION
Mother's/Legal Guardian's Name:
Phone:	Home Work Cell/Pager
Address:
Ward:
Employer:

Father's/Legal Guardian's Name:
Phone:	Home Work Cell/Pager
Address:
Ward:
Employer:

EMERGENCY CONTACT (Contact persons are granted authority when we are unable to reach a Parent/Guardian)
Name:
Relationship:
Phone:	Home Work Cell/Pager
Address:
Ward:
City:	State: Zip Code:

Upload Documents (.zip):


How did you hear about WMST PCHS? (Check all that apply): Friend/Relative who attends WMST PCHS (Name: ) Flyer WMST Recruitment Committee School Guidance Counselor Other (Please Explain: )
	I certify that I have read and understand all of the information above and that all of the information submitted is accurate. I understand that providing false information for purposes of defrauding the government is punishable by law and cause for my son's/daughter's dismissal from school.