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2024/2025 North Clay Middle School Enrollment


This form is for students who wish to enroll at North Clay Middle School. 

*Existing students DO NOT need to re-enroll each year.  
*Students entering 6th grade from Clay Community Elementary Schools DO NOT need to re-enroll.  
*Students may only be enrolled by the parent/legal guardian.  
*Please provide the office with a copy of the student's Birth Certificate, Immunization record, and Proof of Residency (*Examples:  Utility Bill, Mortgage Statement, Rental Agreement.  Must be dated within the last 60 days.)  
*If you do not live in Clay County, please contact Mrs. Irwin at the email below.  An Out of District Transfer Request must be filled out and approved before student can be enrolled.  
*If applicable, please provide a copy of legal guardianship/custody paperwork.
*If you are wanting your student to ride the school bus to and/or from school, you will need to register for transportation at the Clay Community Schools website.

Email the Registrar, Mrs. Irwin, with any questions:  irwinlin@clay.k12.in.us
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Grade Level for 2024/2025 School Year: *
Has the student ever attended Clay Community Schools? *
If answered "Yes" above, please list the CCS school the student last attended:
Student's Legal Last Name *
Student's Legal First Name *
Student's Legal Middle Name *
Student's Preferred Name *
Date of Birth *
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/
DD
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YYYY
Gender *
Primary Phone Number (000-000-0000) *
County of Legal Residence
Proof of Address must be turned into NCMS.
 *
Home Address:
Proof of Address must be turned into NCMS.
*
Mailing Address (if different than Home Address):
Is this student a Foster Child?  (If yes, legal documentation must be provided to the school.) *
Primary Guardian's Name: *
Primary Guardian's relationship to student: *
Primary Guardian's Day Phone Number (000-000-0000): *
Primary Guardian's Home Phone Number (000-000-0000): *
Primary Guardian's Email: *
Primary Guardian's Employer: *
Secondary Guardian's Name:
Secondary Guardian's relationship to student:
Secondary Guardian's Day Phone Number (000-000-0000):
Secondary Guardian's Home Phone Number (000-000-0000):
Secondary Guardian's Employer:
Student Lives With:
*
Sibling First & Last Name(s):
Student's Native Language: *
Is Student Hispanic/Latino? *
Race:  (Choose all that apply) *
Required
Has the student received Special Services at their previous school? *
Name and Address of last school attended: *
Has the student been suspended, expelled, or had unexcused absences during the last 12 months?  *If yes, please list details below:
 *
Emergency Contact(s) Name, Relationship and Phone Number:  (May list up to 3 people) *
Primary Doctor and Phone Number:
Please list any allergies the student may have:
Please list any Special Medical Considerations the student may have:
Please list any medications the student is prescribed:
Will medication need to be given at school?
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Is there anyone, by court order, who should not have contact with this student?  (Legal documentation must be provided to the school.) *
Anticipated start date: *
Name of person enrolling student:  *Must be a Parent or Legal Guardian. *
Relationship to student: *
Please choose Band or Choir.  Placement in these classes will depend on class enrollment numbers. *
Comments:
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