We/I, the undersigned, hereby certify that, to the best of our/my knowledge and belief,
the answers to the foregoing questions and statements made by us/me in this application are complete and accurate.
We/I understand that any false information, omissions, or misrepresentations of facts may result in rejection of
this application or future dismissal of the applicant.
NON-DISCRIMINATION STATEMENT : It is the policy of DSA Elementary to comply with all state and federal
regulations regarding admission and not to discriminate during the admission and the lottery process on the basis of gender,
national origin, ethnicity, religion, disability, academic, artistic, athletic ability, or the district the child would otherwise attend.