Enrollment

New Students Pre-Enrollment Form

Please complete the following enrollment form and upload any required documents.

Required fields marked with an asterisk *

______________________________________________________________

Parent/Guardian Information

Parent/Guardian First Name*

Answer Required

Parent/Guardian Last Name*

Answer Required

Email Address

Answer Required

Primary Phone*

Number Required

Student lives with:*

Answer Required

Address

Physical Address (NO PO Box)*

Answer Required

PO Box

Answer Required

City*

Answer Required

Zip/Postal*

Answer Required

Please Upload your most recent proof of residence

Answer Required

Choose a file or drag it here.

Occupation Information

Place of Employment

Answer Required

Occupation

Answer Required

Work Phone

Answer Required

______________________________________________________________

Student Information

Student First Name*

Answer Required

Student Last Name*

Answer Required

Grade*

Answer Required

Student Birthday*

Answer Required

Proof of Age

Answer Required

Birth Certificate

Baptismal Certificate

Upload Proof of Age Document

Answer Required

Choose a file or drag it here.

Country of Birth

Answer Required

USA

Mexico

Other Country

Answer Required

State of Birth

Answer Required

City of Birth

Answer Required

Immigrant Information

First Day of Attendance in a USA School

Answer Required

Number of school years in attendance in the USA

Answer Required

Last School Attended

Name of School

Answer Required

Address of School

Answer Required

Country

Answer Required

City

Answer Required

State

Answer Required

Zip Code

Answer Required

Race and Ethnicity

Ethnicity

Answer Required

Hispanic or Latino

NOT Hispanic or Latino

Race

Answer Required

American Indian or Alaskan

Asian

Black or African American

Native Hawaiian Other Pacific Islander

White

______________________________________________________________

Nurse Emergency Information

IN CASE OF EMERGENCY: Names of persons who could assume temporary responsability.

Local friend or relative name*

Answer Required

Local friend or relative telephone number*

Number Required

Local friend or relative name*

Answer Required

Local friend or relative telephone number*

Number Required

Local Doctor

Answer Required

Specify health problems/allergies

Answer Required

Is your child on daily medication?

Answer Required

Yes

If Yes Specify

Answer Required

Please upload Vaccines Card

You can take a picture with your cell phone, download it to your computer and upload it here

Answer Required

Choose a file or drag it here.

Upload additional documents(optional)

Answer Required

Choose a file or drag it here.

Gadsden Elementary School District #32

Please fix the highlighted areas below before submitting.

Enrollment