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New Student Enrollment Form Elementary

Student Enrollment Form - Whitehall, Montana Elementary

Gender*
Answer required for "Gender"
Race (check all that apply)*
Answer required for "Race (check all that apply)"
Is your child's first-learned or home language anything other than English?*
Answer required for "Is your child's first-learned or home language anything other than English?"
Does your child understand or communicate with anyone in the home using a language other than English?*
Answer required for "Does your child understand or communicate with anyone in the home using a language other than English?"
Does your child read and/or write in a language other than English?*
Answer required for "Does your child read and/or write in a language other than English?"
Does your child have exposure to a heritage or ancestral language other than English spoken by family, friends, or community members?*
Answer required for "Does your child have exposure to a heritage or ancestral language other than English spoken by family, friends, or community members?"

Primary Household/Members (Please list only those members living at this address)

State*
Answer required for "State"

Mailing Address - if different from physical address.

State
Answer required for "State"

Parent/Guardian 1 Information

Parent/Guardian 2 Information

Siblings

Sibling 1

Sibling 2

Sibling 3

Sibling 4

Sibling 5

Secondary Household/Members (Parent/Guardian NOT living in Primary Household)

Mailing Address

State
Answer required for "State"

Parent/Guardian 1

Parent/Guardian 2

Emergency Contact Information  (May be contacted in case of illness or emergency and must be able to pick up student)

Emergency Contact 1

Emergency Contact 2

Student Specific Information

Does this student have special needs?*
Answer required for "Does this student have special needs?"
If yes, check one:
Answer required for "If yes, check one:"
Court Protection Order?*
Answer required for "Court Protection Order?"
Parenting Plan?
Answer required for "Parenting Plan?"
Medication taken at home?*
Answer required for "Medication taken at home?"
Medication taken at school?*
Answer required for "Medication taken at school?"
Has this student ever been suspended or expelled from school?*
Answer required for "Has this student ever been suspended or expelled from school?"
Is any individual named on this enrollment form (including parent, guardian, sibling, caretaker relative, emergency contact) currently or formerly a registered sex or violent offender?*
Answer required for "Is any individual named on this enrollment form (including parent, guardian, sibling, caretaker relative, emergency contact) currently or formerly a registered sex or violent offender?"

Current or former individuals on the Sex/Violent Offender Reqistry  are NOT permitted on school property or have limited access per District Policy #4015

I certify that I am the legal guardian of the child and that all information provided is true and accurate to the best of my knowledge. I verify that I reside within the school district boundaries or have an approved non-resident status for my child.*
Signature Required

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By pressing “Sign Form,” you are agreeing to signing this form electronically.
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Date:
Confirmation Email