Student Information
Legal Name from Birth Certificate
**Legal Name: **First: Middle: **Last:
**Date of Birth: MM/DD/YYYY
**Gender:
Preferred First Name:
**School:
**Previous School:
Enter NONE in all three boxes
if Kindergarten student
School Name:
City:
State:
**Grade Level: Next Year's Grade Level
**Anticipated Start Date:
Current Special Programs IEP 504 ELL Speech Therapy Gifted and Talented
**Mailing Street/PO Box
**Mailing Address City
**Mailing Address State
**Mailing Address Zip Code
Birth Certificate Please, if possible, upload a copy of the birth certificate for this student here. You must still bring the physical, original copy to the school to complete registration, but it will save you time.
Upload Documents Are there any guardianship/custody documents the school should be aware of? Please upload them here.
Immunization Card
Parent/Guardian Information
**First Name: **Last Name:
**Relationship to Student:
Other Students in Family: Check this box if other members of your family are active students at our schools
**Desired User Name: Desired User Name for PowerSchool Login
**Email:
**Phone: 999-999-9999      Alternate Phone: 999-999-9999
**Street:
**City:
**State:
**Zip Code:
**County
**Verification: I verify that the above information is correct
** Required Information