STUDENT ENROLLMENT FORM 1435 W Auburn Rd., Rochester Hills, MI 48309 * 248-537-6600 * Fax: 248-537-6605 My child has previously been enrolled in Avondale Schools:
Ethnicity Is this student Hispanic/Latino? (choose only one) No, not Hispanic/Latino Yes, Hispanic/Latino (A person of Cuban, Mexican, Puerto Rican, South of Central American, or other Spanish culture of origin, regardless of race)
Middle
Male
Female
Race The question to the left is about ethnicity, not race. No matter what you selected, please continue to answer the following by marking one or more boxes to include what you consider your students race to be.
American Indian/Alaska Native Native Hawaiian/Pacific Islander
Asian American Black/African American
White
Address: __________________________________________________________________________________________________________________ Number
Street
P.O. Box/Apt. #
City
State
Zip
Home Phone: ________________________ Birth Date: ____________________ Birth Place: _____________________________________________ Unlisted
Month/Date/Year
City
State
Zip
School Last Attended: _______________________________________________________________________________________________________ Name
Street Address
Does your child require medication during school hours?
Yes
City
State
Zip
No
If yes, written orders signed by your physician on a form provided by the school office must be presented to the school principal.
Does your child have any specific health problems such as diabetes, seizures, asthma, severe food or bee allergy? Yes No If yes, please specify health problem and treatment necessary. ________________________________________________________________________________________________________________________________________________________________________________________
Please check any services your child has received: None Plan Accommodations Title I/At Risk Support Speech/Language Special Education Service Title III/ESL Support Is your child’s native tongue a language other than English? Yes No Is the primary language used in your child’s home or environment a language other than English? Yes No If yes, what is the primary language?_______________________ If yes, what date did the child enter the US? ______/_______/______ Child lives with:
Father
Mother
Both Parents
Joint Custody
Foster Care
Legal Guardian
Grandparent
Cell Phone with area code:
Name of Primary Parent/Guardian Residing in the Home:
Other Employer: Work Phone with area code:
Relationship:
Father
Mother
Legal Guardian Cell Phone with area code:
Name of Primary Parent/Guardian Residing in the Home:
Employer: Work Phone with area code:
Relationship:
Father
Mother
Legal Guardian
Parent Living Elsewhere: Name
Relationship:
Father
Address:
Mother
Cell Phone with area code:
Legal Guardian
Custody Restrictions:
Have custody papers been provided to the district?
Yes
No
Other children in family living at this residence:
______________________________________________________ Name
Name of Primary Parent/Guardian Residing in the Home: Relationship: Father Mother Legal Guardian. Employer: Work Phone with area code: Cell Phone with ...
Lakeville Area Public Schools ISD #194 ⢠Student Information Services ⢠Revised .... I hereby verify that the above information is true and correct to the best of my ...
Lakeville Area Public Schools ISD #194 ⢠Student Information Services ... been completed and sent to Student Services? ... Part B â Check ALL that apply:.
Private Health Service Plan Enrollment Form ... Incorporated Business? ... Administration Inc. (The Heritage) establishes and manages a Private Health Services ...
It is a pleasure to welcome you to North Huron School District. I am delighted that you have selected. our district for your child and am confident that he/she will ...
Homeless Questionairre (if applicable) ... Birth Certificate or valid passport if not born in the United States. Official ... Male Female Birth Date Grade Entering Multiple Birth Status: Single Twin Triplet ... Student Enrollment Form 2015-2016.pdf.
signature on the Weekly Order Pickup List indicates you have received your ... 7) You must sign a WAIVER OF RESPONSIBILITY form before certificates will be ...
Digital Design. Film and Television Production. For which intake do you wish ... Applicant's signature. Date. /. /. Privacy JMC Academy is committed to preserving ...
Campsite hotel/motel single family dwelling other. Car shelter temporarily living with another family member or friend. Parent/Legal Guardian Signature.
All fields are required. Please contact ... Please send all invoices to c/o Iron ... F: Invoice should include a total of all goods and services and applicable VAT.
Processing Time: Requests received during regular business hours will be processed within 48 hours except during peak times. Peak times are the ... Student ID #:. Telephone: Email: Current Status: â¡ Current Student. â¡ Graduate. â¡ Previously Att
Whoops! There was a problem loading more pages. Retrying... 2016-17 Enrollment Form -CH.pdf. 2016-17 Enrollment Form -CH.pdf. Open. Extract. Open with.
To enroll: Mail to SYSA, P.O. Box 1113, Salem, OR 97308 or bring to rehearsal. 1. Player Profile complete with all information IF not previously submitted. 2. $25 nonrefundable enrollment fee for each member, check payable to SYSA. 3. Emergency Conta
To enroll: Mail to SYSA, P.O. Box 1113, Salem, OR 97308 or bring to rehearsal. 1. Player Profile complete with all information IF not previously submitted. 2. $25 nonrefundable enrollment fee for each member, check payable to SYSA. 3. Emergency Conta
a relative, friend(s) or other adult(s) alone with NO adults an adult that IS NOT the parent or the legal guardian. Douglas County School: Student's Legal Name:.
Billing Division or Location: 1508319. A. Employee Information (Complete for ALL ... Date of Full-Time Employment: Rehire Date: B. Product Selection (Complete for ALL ... for coverage for my dependents at a later date, and if a physical examination o
Form 3730 Rev. 12061. TrÆ°á»ng TÆ°. Page 2 of 2. AUSD Enrollment Form 2017 VIET.pdf. AUSD Enrollment Form 2017 VIET.pdf. Open. Extract. Open with. Sign In.
