K-8 Admission Forms Admission Forms Step 1Step 2Step 3Step 4Step 50% Complete1 of 5 Enrollment Application Form Student ID Number Enrollment Date Grade Entering * Scholarship * Student's Legal Name * Student's Legal Name First First Last Last Date of Birth * Age * Social Security Number * Place of Birth Address * Address Address Address City City State/Province Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State/Province Zip/Postal Zip/Postal Phone Number * Email * Gender * Plase Select An Option Male Female Ethnic Plase Select An Option Non-Hispanic Hispanic Race Plase Select An Option White Asian American Indian / Alaska Native Black or African American Native Hawaiian or Other Pacific Islander Student Lives With * Plase Select An Option Both Parents Mother Only Legal Guardian Father Only Who has legal responsibility for school decisions ? * Other Children's Living at Home ? * Plase Select An Option Yes No How Many Children? * Plase Select An Option 1 2 3 Child 1 Child's Name * Child's Name First First Last Last Relation to Student * School Grade Child 2 Child's Name * Child's Name First First Last Last Relation to Student * School Grade Child 3 Child's Name * Child's Name First First Last Last Relation to Student * School Grade Special Service Testing ? * Plase Select An Option Yes No Checkboxes * Speech Attention-deficit/hyperactivity disorder Learning Disabilities Emotional Impairment Does the student most frequently speak a language other than English? * Plase Select An Option Yes No What Languages? * Did the student have a first language other than English? * Plase Select An Option Yes No What Language? * Is a language other than English spoken at home? * Plase Select An Option Yes No What Language? * Has the student ever been dismissed from a previous school? * Plase Select An Option Yes No Please Explain * Has the student ever experienced academic, behavior, emotional, or attention difficulties that resulted in discussion or evaluation by a school official, psychologist, or other professionals? * Plase Select An Option Yes No Please Give Details * Has the student been identified as a special education student or has an active Individualized Education Program? * Plase Select An Option Yes No Does the student have a current 504? * Plase Select An Option Yes No Is the student a participant of the Gardiner or McKay scholarship? * Plase Select An Option Yes No Which One? Did the student study in another school? * Plase Select An Option Yes No Last three schools attended (Begin with the most recent- For Kindergarten, please list PRE-K, VPK, Head Start) if applicable Plase Select An Option 1 2 3 School 1 Type of School * Plase Select An Option Public Home Private Education Name of the School * City, State * Years Attended * Grade * School 2 Type of School * Plase Select An Option Public Home Private Education Name of the School * City, State * Years Attended * Grade * School 3 Type of School * Plase Select An Option Public Home Private Education Name of the School * City, State * Years Attended * Grade * Signature * Clear Date * Relationship to Student * If you are human, leave this field blank. Next
