Re-enrollment application

Elementary re-enrollment form

Student's Name/Estudiante Nombre

Student's legal first name:

​

Student's legal last name:

Gender

Female

Male

Enrolling Grade /Grado que solicit

Applying for School Year: 

Birth Date/Fecha de nacimiento

Home Address/Dirección

Zip Code/Código postal

Phone number: 

Parent/Guardian Information/Información para los padres

Parent/Guardian Name/Nombre

Parent/Guardian Name/Nombre

Address/Dirección (if different from above)

Zip Code/Código Postal

Phone/Teléfono

E-mail Address/Correo electónico

Health / Medical Information

During school hours does your student require any medication?

Yes

No

If you selected "Yes", please explain:

Does your student have any other condition which causes the daily possibility of a life-threatening emergency? 

Yes    No

If you selected "Yes", please explain:

Emergency Contact Information

Name:

Relationship:

Phone Number:

 

Name:

Relationship:

Phone Number:

 

Name:

Relationship:

Phone Number:

 

Language Preference/Idioma Principal

Please select the uniform shirt size your student will need next year:

Youth XL

Youth L

Youth M

Youth S

Toddler 5 (T5) (PK students)

Toddler 4 (T4) (PK students)

Additional Details/Mas Informacion                    

By typing my name in the box noted below I am acknowledging that I have filled out this form completely and accurately.

Name:

Date:

 

 



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