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Application for Enrollment

Please complete all application sections below. After submission, our Enrollment Coordinator will contact you to bring in additional registration documents.

How Did You Hear About Us? Select all that apply:

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This Website

Friend/Family

Social Media

School Referral

Community Event

Other

Name of adult at your school who referred you to PECHS:

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Choose Your Preferred Campus. Select One:*

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Second Chance Campus - 5114 South Elizabeth Street, Chicago, IL 60609

Sinclair Campus - 4946 S. Paulina, Chicago, IL 60609

I'd prefer to visit before making a choice

Student's Personal Information

Last Name:*

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First Name:*

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Birthdate:*

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CPS Student ID Number:

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Age at Time of Application:

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Student Cell Phone #:

Number Required

Student Email Address:

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Parent/Guardian Information

Mother's/Guardian's Name (First and Last):

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Mother's Phone #:

Number Required

Mother's Email Address:

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Address 1:

Mother's/Guardian's address

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Address 2:

Mother's/Guardian's address

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City:

Mother's/Guardian's address

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State:

Mother's/Guardian's address

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Zip:

Mother's/Guardian's address

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Father's/Guardian's Name (First and Last):

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Father's Phone #:

Number Required

Father's Email Address:

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Address 1:

Father's/Guardian's address

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Address 2:

Father's/Guardian's address

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City:

Father's/Guardian's address

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State:

Father's/Guardian's address

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Zip:

Father's/Guardian's address

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Emergency Information

Name of Emergency Contact #1:

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Emergency Contact #1 Phone Number:

Number Required

How is the Emergency Contact #1 related to you?

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Name of Emergency Contact #2:

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Emergency Contact #2 Phone Number:

Number Required

How is Emergency Contact #2 related to you?

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Educational Information

Number of High School Credits Earned:

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Year of 8th Grade Graduation:

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Name of Grammar School:

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Last High School Attended:

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Other High School Attended:

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Other High School Attended:

If applicable, list a second additional school

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Essay Section

Essay Question (Option #1) - If you were enrolled at PECHS before and left, explain your reasons for leaving. Why are you interested in re-enrolling at Peace and Education Coalition? (Type N/A if this question does not apply to you) Previous Peace and Education Coalition students only:

Answer required for "Essay Question (Option #1) - If you were enrolled at PECHS before and left, explain your reasons for leaving. Why are you interested in re-enrolling at Peace and Education Coalition? (Type N/A if this question does not apply to you) Previous Peace and Education Coalition students only:"

Essay Question (Option #2) - Write about your previous high school experience. Why are you no longer enrolled there? How can Peace and Education Coalition help you complete high school? (Type N/A if this question does not apply to you) New applicants only:

Answer required for "Essay Question (Option #2) - Write about your previous high school experience. Why are you no longer enrolled there? How can Peace and Education Coalition help you complete high school? (Type N/A if this question does not apply to you) New applicants only:"

Confirmation Email

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