Student Enrollment Form (Elementary School Or Middle School) Page 2
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3SECTION II: RESIDENCY INFORMATION
Are you the owner of your child’s residence within this school’s attendance zone?
______ Yes
______ No
• If yes, what is the PARCEL NUMBER / TAX MAP PAGE of this residence? (Can be found on annual tax bill)
_______________________________________________________
• If no, please ask the school for the necessary affidavit to be filled out by the property owner/manager.
Residence Address:
Mailing Address (if different):
Address ________________________________
Address ______________________________
City ___________________________________
City _________________________________
State _________
Zip Code ___________
State ________
Zip Code____________
Phone Numbers:
_____________________
_______________________
__________________
Home
Cell
Work
With whom does student live? ____ Both parents
____ Father only
____ Mother only
____ Mother and Stepfather
____ Father and Stepmother
____ Legal Guardian
(Documentation required)
_________________________________________________________________________________________
SECTION III: PARENT / LEGAL GUARDIAN INFORMATION
_____________________________________
_____________________________________
Relationship (Father, Mother, Legal Guardian)
Relationship (Father, Mother, Legal Guardian)
_____________________________________
______________________________________
Last Name
Last Name
_____________________________________
______________________________________
First Name
First Name
Contact allowed?
_____ Yes
_____ No
Contact allowed? _____ Yes
_____ No
_____________________________________
______________________________________
Address
Address
________________
__________
________
_______________
_______
_________
City
State
Zip Code
City
State
Zip Code
Phone Numbers:
Phone Numbers:
______________________
_______________
________________
____________
Home
Cell
Home
Cell
______________________
_________________
Work
Work
__________________________________________
_____________________________________
Employer
Employer
__________________________________________
_____________________________________
Occupation
Occupation
Email Address ______________________________
Email Address _________________________
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