PSA Waiting List

Public Safety Academy
1494 E. Art Townsend Drive, San Bernardino, CA 92408 (909) 382-2211
A P P L I C A T I O N
San Bernardino Residents Please Include Proof of Residency with Application
Copy of Current Utility Bill showing your name and address and Driver’s License

Our program requires students to be in attendance each day school is open. Parental involvement, high standards of discipline and maximum attendance are part of our continuing effort to provide your child with the highest level of academic opportunity. We expect parents of our full time students to be highly committed to and engaged in their children’s educational program.

* Student’s CURRENT grade

* Date of Birth

* First Name

* Last Name

* Parent / Gaurdian name

* Parent/Gaurdian Last Name

* Street Address

Address Line 2

* City

* State

* Zip Code

* Phone Number

* Email Address

* PLEASE LIST THE NAME OF YOUR CHILD’S CURRENT SCHOOL

Enrollment requirements include: Copy of most recent report card, most recent test scores, discipline record, and proof of residency.

Having a child in the PSA does not guarantee placement for other family members. When applications exceed our capacity, admissions are based on grade level availability and processed in the order received.

* Has this student ever been expelled from school?

* Name of school

* Has this student ever received special services?

I understand the above statements as well as all policies articulated in the PSA Charter and will abide by the requirements of The Public Safety Academy.

Incomplete applications or missing proof of residency will delay placement on the waiting list. Selection for openings will be taken in the order received.

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