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New Student Enrollment (Instance: new, Process: Student_Registration, Version: 1, Step: 1)
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Instructions:
Please enter student information.
All fields in red require input.
Click on "Send" button when complete.
Student Information
 
As appears on Birth Certificate
As appears on Birth Certificate
As appears on Birth Certificate
 
 
 
Please Check All that Apply
*one selection is required.
  
  
  
  
  
 
 
Student Residence / Home
 
Previous Education
 
Name of Previous School or Preschool (for Kindergarten Children Only)
 (mm/dd/yyyy)
 
 
Please Check All that Apply
  
  
  
  
 
Please Check All that Apply
  
  
  
 
Parent/Guardian/Custody Information
Please Check All That Apply:
(Please check at least one)
  
  
  
  
  
  
  
  
Primary Contact
Primary contact is the person (or persons) responsible for the regular care of the student and to whom the school may send school-related correspondence. The primary contact is also the first point of contact for the school in the unlikely event that the child is injured or becomes ill while at school. In general, the Primary Contact refers to the parent(s) or guardian(s) of the student.
  
 
Phone Number(s)
Phone Type Phone Number
  Add row(s)  Delete selected row(s) 
To add row click on +
to delete select checkbox for row and click on -
 
 
Please Check All that Apply
  Please ONLY choose this if this contact is Parent or Legal Guardian
  
  
  
  
In the event that the school is unable to reach the Primary Contact, parents are encouraged to provide at least one and up to 5 additional contacts whom the school may call in the unlikely event that this student is injured or becomes ill while at school.
 
IMPORTANT NOTE: Primary and additional contacts are the only persons authorized to pick up a child from school. As a result, please create an additional contact below for those individuals whom you authorize to pick up your child from school in place of a parent or legal guardian.
Additional Contact (1)
Additional person whom we may contact in an emergency situation
 
  
 
Phone Number(s)
Phone Type Phone Number
  Add row(s)  Delete selected row(s) 
To add row click on +
to delete select checkbox for row and click on -
 
 
Please Check All that Apply
  Please ONLY choose this if this contact is Parent or Legal Guardian
  
  
  
  
  
 
Additional Contact (2)
Additional person whom we may contact in an emergency situation
 
  
 
Phone Number(s)
Phone Type Phone Number
  Add row(s)  Delete selected row(s) 
To add row click on +
to delete select checkbox for row and click on -
 
 
Please Check All that Apply
  Please ONLY choose this if this contact is Parent or Legal Guardian
  
  
  
  
  
 
Additional Contact (3)
Additional person whom we may contact in an emergency situation
 
  
 
Phone Number(s)
Phone Type Phone Number
  Add row(s)  Delete selected row(s) 
To add row click on +
to delete select checkbox for row and click on -
 
 
Please Check All that Apply
  Please ONLY choose this if this contact is Parent or Legal Guardian
  
  
  
  
  
 
Additional Contact (4)
Additional person whom we may contact in an emergency situation
 
  
 
Phone Number(s)
Phone Type Phone Numbe
  Add row(s)  Delete selected row(s) 
To add row click on +
to delete select checkbox for row and click on -
 
 
Please Check All that Apply
  Please ONLY choose this if this contact is Parent or Legal Guardian
  
  
  
  
  
 
Additional Contact (5)
Additional person whom we may contact in an emergency situation
 
  
 
Phone Number(s)
Phone Type Phone Number
  Add row(s)  Delete selected row(s) 
To add row click on +
to delete select checkbox for row and click on -
 
 
Please Check All that Apply
  Please ONLY choose this if this contact is Parent or Legal Guardian
  
  
  
  
  
 
District-wide Notification System
From time to time, the district or school sends notification via telephone and email of school closings, district news, events or, in rare instances, emergency situations. Please provide at least one phone number and email address to which the district should send these notifications.
  
Leave blank if you don`t want news
Leave blank if you don`t want news
Child Medical Care
Primary Medical Contact(s)
Primary Physician
Dentist
Medical Specialist
Preferred Hospital / ER
Medical Conditions and Special Care
Please provide information about medical conditions your child has, special care that may be required for your child while at school or school events, and/or medications your child takes. This information, which will remain confidential, will be helpful to the school staff in the unlikely event that your child is involved in an emergency while at school or at a school-sponsored event.
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Check here if special care or administration of medication may be required at school. Additional requests for information will be sent home by the district medical staff.
Child Care Provider
Child Care Provider Information
Transportation
CONSENT - Part I or Part II must be completed
GRANT CONSENT
In the event that reasonable attempts to contact me have been unsuccessful, I hereby give my consent for (1) the administration of any treatment deemed necessary by above-named doctor, or, in the event the designated preferred practitioner is not available, by another licensed physician or dentist; and (2) the transfer of the child to any hospital reasonably accessible. This authorization does not cover major surgery unless the medical opinion of two (2) other licensed physicians or dentists, concurring in the necessity for such surgery, are obtained prior to the performance of such surgery.
REFUSAL TO CONSENT
I do NOT give my consent for emergency medical treatment of my child. In the event of illness or injury requiring emergency treatment, I wish the school authorities to take the following action:
Annual Parent Notification & Consent
  Click for the K-5 Student Handbook
  Click for the High School Student Handbook
  Click for the Middle School Student Handbook
Documents that require signatures - please complete and return to school as soon as possible
 
  Click here to download a copy of this checklist
  Click here to download Home Language Survey
 
  Click here to download Medical Health form
  Click here to download Oral Assessment form
Signature
  << Please check here