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Online School Enrollment Form
 

 
Enrollment Status
Enrollment Status
Enrollment Request Date
Email
The email(s) will receive a confirmation of the enrollment and a link that will allow you to return to this page to review your enrollment or check its status.
Email 1
 Required Dot
Retype Email 1  Required Dot

Email 2
Retype Email 2
Student
First Name
Please provide identification information for the student.

You must give us the first and last name and the date of birth.

But if you have the additional information please provide it. It makes for easier identification if there are 2 students with the same first and last names.
 Required Dot
Middle Name
Last Name  Required Dot
Date Of Birth
RadDatePicker
RadDatePicker
Open the calendar popup.
 Required Dot
Country of Birth
State of Birth
City of Birth
Gender


Race/Ethnicity
American Indian or Alaska Native (A person having origins in any of the original peoples of North and South America (Including Central America) and who maintains tribal affiliation or community attachment)

Asian - (A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam)

Black or African American (A person having origins in any of the black racial groups of Africa)

Native Hawaiian or Other Pacific Islander (A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands)

White (A person having origins in any of the original peoples of Europe, the Middles East or North Africa)
Hispanic
White     Black or African American     Asian
American Indian or Alaska Native
Native Hawaiian or Other Pacific Islander    














Member of Military Family
Your child as a Military Family member is eligible for assistance if either parent meets any of the following conditions: Active duty members of the uniformed services, National Guard and Reserve on duty orders and /or Members or veterans who are medically discharged or retired or die on active duty for one (1) year.




Student Phones
Home Phone
Please provide the phone numbers of the student.

You will be asked for parent/guardian information further down, at that time you can provide specific phone numbers for parents/guardians.
 Required Dot
Cell Phone
Other Phone
Other Phone Description


Home or Residence Address
Address
Provide your Home or Residence Address. This is required information.
 Required Dot
Appt/Blg
City  Required Dot
State  Required Dot
Postal Code  Required Dot
Mailing Address
Address
Provide a Mailing Address only if it is different than your Home Address.

Appt/Blg
City
State
Postal Code
School and Grade
School And Grade of Enrollment
Provide the school and grade you are enrolling into.

Additionally provide us with the school and grade the student is currently attending.

Use the Comment box to provide additionnal information you deem relevant.
 Required Dot
Current School and Grade
Current School District
Current School
Current School - Address
Current School - City
Current School - State
Current School - Postal Code
Current School - Phone
Current School - Fax
Current Grade
Comment
Special Education
Receiving Special Education
Is the student receiving Special Education services. Please describe services.

Please Describe
English Language Learners
Receiving ELL Services
Is the student receiving English Language Learners services. Please describe services.

Please Describe
Is a Language other than English spoken at home?
Please specify other language
Other Children in Family
Name School Grade Date of Birth
RadDatePicker
RadDatePicker
Open the calendar popup.
RadDatePicker
RadDatePicker
Open the calendar popup.
RadDatePicker
RadDatePicker
Open the calendar popup.
RadDatePicker
RadDatePicker
Open the calendar popup.
RadDatePicker
RadDatePicker
Open the calendar popup.
First Parent/Guardian
Relation to Student
We require that you provide the first and last names for a Parent/Guardian of the student.

We also require that you specify the relation of this person with the student.

Please provide additional phone numbers if need be (for instance the Cell phone of the Parent/Guardian.
 Required Dot
First Name  Required Dot
Middle Name
Last Name  Required Dot
Home Phone
Cell Phone
Work Phone
Other Phone
Other Phone Description
Alert Phone
Enter the phone number that we will use to alert this parent/guardian of snow days, early release, etc.
Email
Other Email
Occupation
Current Place Of Employment
Second Parent/Guardian
Relation to Student
You may provide us with a second Parent/Guardian if you so choose.
First Name
Middle Name
Last Name
Home Phone
Cell Phone
Work Phone
Other Phone
Other Phone Description
Alert Phone
Enter the phone number that we will use to alert this parent/guardian of snow days, early release, etc.
Email
Other Email
Occupation
Current Place Of Employment
Emergency Contact 1
Relation to Student
You may provide us with an emergency contact that will assume temporary care of your child if you cannot be reached.
First Name
Last Name
Address
City
State
Postal Code
Home Phone
Cell Phone
Emergency Contact 2
Relation to Student
You may provide us with a second emergency contact.
First Name
Last Name
Address
City
State
Postal Code
Home Phone
Cell Phone
Emergency Contact 3
Relation to Student
You may provide us with a third emergency contact.
First Name
Last Name
Address
City
State
Postal Code
Home Phone
Cell Phone