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Student Information
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Student's Legal Last Name
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Your answer
Student's Legal First Name
*
Your answer
Student's Legal Middle Name
*
Your answer
Birth Date
*
MM
/
DD
/
YYYY
Gender
*
Male
Female
Primary Language Spoken at Home
*
Your answer
Birth Country
*
Your answer
Grade for 2020-2021 School Year
*
Your answer
School Transferring From
Your answer
Date of Original Entry in U.S. School
MM
/
DD
/
YYYY
Race (check all that apply)
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American Indian or Alaskanm Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
Two or More Races
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Ethnicity (check one)
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None
Hispanic/Latino
Has the student ever received special education services
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Yes
No
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