Student Data Sheet - Wake County Public School System
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1
2STUDENT DATA SHEET
Page 1 of 2
INSTRUCTIONS
Complete this form for each child you are enrolling. A complete list of items required for enrollment can be found at
For assistance, contact your base school or the WCPSS Office of Student Assignment at (919) 431-7333.
STUDENT INFORMATION
Student’s Legal Last Name
Student’s Legal First Name
Student’s Legal Middle Name
Date of Birth (mm/dd/yyyy)
Sex
Primary Phone Number
(
)
-
Male
Female
Current Grade
Is the student Hispanic/Latino? (This information is used for US. Census data.)
Yes
No
Which category best describes the student’s race? (This information is used for US. Census data).
American Indian or Alaska Native
Asian
Black or African American
White
Native Hawaiian or other Pacific Islander
FAMILY INFORMATION
Mother/Stepmother’s First Name
Mother/Stepmother’s Last Name
Mother/Stepmother’s Place of Employment
Mother/Stepmother’s Email
Mother/Stepmother’s Cell Phone
Mother/Stepmother’s Work Phone
(
)
-
(
)
-
Father/Stepfather’s First Name
Father/Stepfather’s Last Name
Father/Stepfather’s Place of Employment
Father/Stepfather’s Email
Father/Stepfather’s Cell Phone
Father/Stepfather’s Work Phone
(
)
-
(
)
-
Legal Custodian’s First Name (if not parent)
Legal Custodian’s Last Name
Legal Custodian’s Place of Employment
Legal Custodian’s Email
Legal Custodian’s Cell Phone
Legal Custodian’s Work Phone
(
)
-
(
)
-
CONTINUED ON NEXT PAGE >
FOR OFFICE USE ONLY
Registering school
School number
Entry date (mm/dd/yyyy)
Entry code
E1
|
E2
|
R2
|
R3
|
R5
|
R6
PowerSchool #
Teacher
Track
Revised Jan. 2014
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