Hopewell Area School District Kindergarten Registration
Welcome to the online Kindergarten registration for the Hopewell Area School District. You will be able to proofread these forms when you officially sign them. Should you have any questions or concerns, please do not hesitate to contact one of the elementary buildings.
Child's Last Name
Your answer
Child's First Name
Your answer
Child's Middle Name
Your answer
Child's Date of Birth
MM
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DD
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YYYY
Child's Birthplace (City, state)
Your answer
Country of Child's Birthplace
Primary Language Spoken at Home by the child
Other Language Spoken by this child fluently
Has your child ever received English as a Second Language Services
Child's Gender They Identify With
Child's Ethnicity
Child's Allegies
Child's Allegies
If you answered yes to the above question, please explain what allergies your child has as well as any medication that is needed both at home and at school.
Your answer
Child's Medication
Child's Medication
If your child is on regular medication, please answer what the medication is, what the medication is addressing, and whether it would be administered at school.
Your answer
Child's Injuries
Please list any operations, injuries, or hospitalizations your child has had (with dates). If they have had none, please enter none.
Your answer
Medical History
Please check all that apply
Physical Activity
Does your child have any physical limitations?
If you answered that your child has limited physical activity, please explain
Your answer
Your Child's Vision
Is your child under medical treatment
If your child is under medical treatment, please list the doctors name and reason for treatment.
Your answer
Does your child have any known serious sensitivity or other conditions requiring immediate medical attention? (If they do not have one please write none).
Your answer
Child's Currently Resides With
Your current home address (include city, and zip code please)
Your answer
Alternative address for Childcare Purposes
Your answer
Child's Father's Name
Your answer
Child's Father's Date of Birth
MM
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DD
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YYYY
Child's Mother's Name
Your answer
Child's Mother's Date of Birth
MM
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DD
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YYYY
Home Phone Number (Primary Number)
Your answer
Cell Number (Mother)
Your answer
Cell Number (Father)
Your answer
Mother's Work Number
Your answer
Father's Work Number
Your answer
In the event of an emergency and we are unable to reach you, please provide us with an emergency contact name, address, phone number, and relationship to the student.
Your answer
Did your child attend pre-school, Head Start, or Early Intervention?
If your child attended pre-school, Head Start, or Early Intervention, what is the name and address of the school.
Your answer
Date your child started school (month/year)
Your answer
Has your child ever attended the Hopewell Area School District?
Has your child ever participated in a Special Education program?
If your child has participated in a Special Education program, please explain.
Your answer
Has your child participated in any remediation program such as Title 1?
If your child participated in a remediation program, please explain.
Your answer
Which grade do you anticipate your child entering
Census Questionnaire
Please answer each question below regarding the individuals residing in your home. If you require more room, you will be able to add more people when you sign your registration documents. You will need to identify one adult as the "head of the household."
Name of the head of the household-Title
Title
Name of the head of the household-Last Name
Your answer
Name of the head of the household-First Name
Your answer
Name of the head of the household-Date of Birth
MM
/
DD
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YYYY
Head of the household-Home Address, please include city, state, and zip code
Your answer
Head of the household-Occupation
Your answer
Head of household-PRIMARY PHONE NUMBER
Your answer
Head of the household-Employer
Your answer
Head of the household-Employer Address (Please include city, state, and zip code)
Your answer
Head of the household-Employer Phone Number
Your answer
Other Adult Residing at this Address (if applicable)- Title
Other Adult Residing at this Address (if applicable) Last Name
Your answer
Other Adult Residing at this Address (if applicable) First Name
Your answer
Other Adult Residing at this Address (if applicable) Date of Birth
MM
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DD
/
YYYY
Other Adult Residing at this Address (if applicable) Employer Name
Your answer
Other Adult Residing at this Address (if applicable) Employer Address
Your answer
Other Adult Residing at this Address (if applicable) Employer Phone Number
Your answer
Other Adult Residing at this Address (if applicable) Occuptation
Your answer
1st Minor Residing at this Address-Last Name
Your answer
1st Minor Residing at this Address-First Name
Your answer
1st Minor Residing at this Address-Date of Birth
MM
/
DD
/
YYYY
1st Minor Residing at this Address-School Attending (if applicable)
Your answer
1st Minor Residing at this Address-School Address (if applicable)
Your answer
2nd Minor Residing at this Address-Last Name
Your answer
2nd Minor Residing at this Address-First Name
Your answer
2nd Minor Residing at this Address-Date of Birth
MM
/
DD
/
YYYY
2nd Minor Residing at this Address-School Attending (if applicable)
Your answer
2nd Minor Residing at this Address-School Address (if applicable)
Your answer
3rd Minor Residing at this Address-Last Name
Your answer
3rd Minor Residing at this Address-First Name
Your answer
3rd Minor Residing at this Address-Date of Birth
MM
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DD
/
YYYY
3rd Minor Residing at this Address-School Attending (if applicable)
Your answer
3rd Minor Residing at this Address-School Address (if applicable)
Your answer
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