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Student Enrollment Form
Student Enrollment Form
Last Name *
Your answer
First Name *
Your answer
Middle Name
Your answer
DOB *
MM
/
DD
/
YYYY
Grade Level *
School Preference - 1st Choice for grades K-5
School Preference - 2nd Choice for grades K-5
School Preference - 3rd Choice for grades K-5
School Preference - 4th Choice for grades K-5
Gender *
Your answer
Phone Number *
Your answer
Student Race *
Is the student Hispanic or Latino? *
Date first entered School *
Your answer
Date first entered KS school *
Your answer
Has your family moved in the last 36 months to seek or obtain agriculture or fishing related work? *
If yes, was the move from one school district to another? *
With whom does this student live? *
Mother's Name
Your answer
Mother's Cell
Your answer
Father's Name
Your answer
Father's Cell
Your answer
Guardian's Name *
Your answer
Guardian's Cell *
Your answer
Student's Home Street Address *
Your answer
City *
Your answer
State *
Your answer
Zipcode *
Your answer
Email address you wish to be contacted at *
Your answer
Previous school student was enrolled at *
Your answer
Previous school address *
Your answer
Previous school phone number
Your answer
Does your student currently have an IEP or other educational plan? *
Is your student under any form of suspension? *
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