This form should ONLY be used for grade 5 students who reside in West Hartford and are NOT currently attending West Hartford Public Schools.

Current 5th grade students who are attending West Hartford Public Schools as of January 8, 2021 are automatically part of the process. Do not complete this form if your student is attending a West Hartford public school.

Please complete one form per student applying for admission.

Grade 6 lottery applications are due January 8, 2021

Student Information

First Name

Middle Name

Last Name

Student's Current School

Street Address

City

West Hartford

State

Zip Code

Parent / Guardian 1 Information

Parent/Guardian 1 Daytime Phone

Parent/Guardian 1 Evening Phone

Parent/Guardian 1 Cell Phone

Parent/Guardian 1 Email Address

Parent/Guardian 1 Relationship to Student

Parent / Guardian 2 Information

Parent/Guardian 2 Daytime Phone

Parent/Guardian 2 Evening Phone

Parent/Guardian 2 Cell Phone

Parent/Guardian 2 Email Address

Parent/Guardian 2 Relationship to Student

Ready to Submit

Please note: This lottery application is only for West Hartford students who do NOT currently attend a West Hartford public school. If your student is already attending a West Hartford public school, do not complete this form.

This lottery is open only to students who are West Hartford residents. We do not require that you establish residency at this time. However, should your student be selected in the lottery, you will need to register your student and prove residency with WHPS before the space can be assigned to your student.

For more details on the residency requirements for WHPS, please visit the residency website.

If you have any questions, please contact Bristow Middle School at 860-231-2100.

A receipt of submission will be sent to the Parent/Guardian 1 email address. If you do not receive the email after 24 hours, please be sure to check your spam folder.