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Student Weighted Lottery Application for 2024-2025

Please complete the form below.  Each student requires a separate application. Required fields marked with an asterisk *

Answer Required

Parent/Guardian Information:

How did you hear about PVS?*
Answer Required

Portland Village School does not discriminate against any person on the basis of race, color, national origin, creed, religion, sex, ethnicity, sexual orientation, mental or physical disability, ancestry, athletic ability, special needs, English language proficiency, or academic achievement in admission or participation in its programs, services, activities or employment.

PVS Equitable Lottery Demographic Information Form

Historically underserved students who meet at least two of the four identified historically underserved criteria will be entered into the lottery three times (as opposed to one time for other students):

  • Historically underserved students based on race (includes only: African American, Pacific Islander/Native Hawaiian, American Indian/Alaska Native)
  • Historically underserved students based on ethnicity (includes only Hispanic)
  • Economically disadvantaged students (Directly Certified/Free and Reduced Price Meals Program & Head Start)
  • English language learners (Emergent bilingual students or students who are continuing to develop their home language while also learning an additional language)

Answering the following questions about race, ethnicity, socioeconomic status and language is optional.  Your answers will help PVS determine your student's status for the weighted lottery.

Is your child part of a historically underserved group per ORS 338.125? Please check ALL that apply:
Answer Required
What is your child's race? Please check ALL that apply:
Answer Required
What is your child's ethnicity or origin?
Answer Required
My child is currently enrolled in the following programs and/or receives the following services:
Answer Required

By signing below you are certifying your agreement to the following:

  • I authorize the release of my child's school records to Portland Village School once enrolled.
  • I authorize PVS staff to contact my child's current and/or past school/teacher(s).
  • I understand all of the information disclosed on this application is kept confidential.
  • All of our contact information is current; it is my responsibility to contact the Front Office with any changes.
  • I understand that it is my responsibility to ensure that the school has received my application.
  • I understand that it is my responsibility to provide copies of two documents showing proof of residence (defined as utility bills and/or official pieces of identification) and passport, birth/baptismal certificate, official document stating birthdate with this application.
Required for application process to be completed: Please attach photo of passport, birth certificate or baptismal certificate of child AND two proofs of address (ie: utility bill, mortgage or rental statement, etc) below.
Answer Required
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DUE DATE: Wednesday, April 3rd, 2024

(Applications may be submitted after 4/03/24 and will be considered late applications and be entered into the waitlist in the order received)

Please direct application and Admissions questions to:

Email: [email protected]



Confirmation Email