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Searcy School District Elementary School Enrollment Form
Please complete the general student information form.
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Student First Name
*
Your answer
Student Middle Name (Optional)
Your answer
Student Last Name
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Your answer
Birthdate (mm-dd-yyyy)
*
Your answer
Nickname (optional)
Your answer
Gender
Female
Male
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Hispanic/Latino Ethnicity
*
Yes
No
Primary Race (Please select only ONE)
*
American Indian or Alaska Native ( A person having origins in any of of the original peoples of North and South America, including Central America, and who maintains tribal affiliation or community attachment)
Asian (A person having origins in any of the original peoples of Far East, Southeast Asia, or the Indian subcontinent, including, for example, Cambodia, China, India , Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam)
Black or African American (A person having origins in any of the black racial groups of Africa)
Native Hawaiian or Other Pacific Islander (A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands)
White ( A person having origins in any of the original peoples of Europe, Middle East, or North Africa)
Additional Races
American Indian/Alaska Native
Asian
Black
Native Hawaiian/Other Pacific Islander
White
Clear selection
Language Spoken at Home
*
Chinese
English
Spanish
Urdu
Vietnamese
Other:
Primary Contact Email
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Your answer
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