Editing previous response:

Please fix the highlighted areas below before submitting.

New Student Enrollment Form Elementary

Student Enrollment Form - Whitehall, Montana Elementary

Answer Required
Race (check all that apply)*
Answer Required
Is your child's home language anything other than English?*
Answer Required

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

Answer Required

Mailing Address - if different from physical address.

Answer Required

Parent/Guardian 1 Information

Parent/Guardian 2 Information


Sibling 1

Sibling 2

Sibling 3

Sibling 4

Sibling 5

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

Mailing Address

Answer Required

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
If yes, check one:
Answer Required
Court Protection Order?*
Answer Required
Parenting Plan?
Answer Required
Medication taken at home?*
Answer Required
Medication taken at school?*
Answer Required
Has this student ever been suspended or expelled from school?*
Answer Required
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

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

Sign this form

By pressing “Sign Form,” you are agreeing to signing this form electronically.
Signature *
Type to sign
Draw your signature

Confirmation Email