SCHOOL YEAR 2020-2021: ENROLLMENT FORM
Use this form to enroll each of you new or returning students to ARE.
Submit this form online. All questions must be answered. PLEASE COMPLETE ONE APPLICATION PER CHILD
CHILD'S INFORMATION
New or Returning Student *
Is this student new or returning to ARE?
ARE PROGRAM *
Required
Student First Name *
Student Middle Name *
Student Last Name *
Student Suffix
Date of Birth *
MM
/
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Age as of today
Student's Gender *
Street Address *
Apartment Number
City *
Required
State *
Required
Zip Code *
Ward *
Country of Birth *
Housing Status *
Choose only one
Required
Ethnic Designation *
Choose only one. This question and its response choices are determined by the District of Columbia, which requires all schools to collect this information.
Required
Race *
check all that apply.
Required
Does your child wear glasses? *
Required
Does your child have asthma? *
Required
Does your child have seizures? *
Required
Does your child have diabetes? *
Required
Does your child have 504 Plan? *
Required
Does your child have IEP for special education services? *
Required
Does your child require medication? *
Required
Does your child have dietary restrictions? *
Required
Please explain below any details about your child's learning that you would like us to know. *
Student's Home Language(s) *
School Last Attended: *
If no school, enter NA
Last Grade Completed *
City and State of Last School Attended *
Type of School *
Student Siblings
Please list ALL siblings that will be attending ARE in this section.
Does the student have siblings that will enroll in ARE? *
Please list each child(s) first and last name(s) seperated by a comma (ex. Jane Doe, John Doe) *
PARENT/GUARDIAN/CUSTODIAN
1. Parent or Guardian First Name *
Parent or Guardian Last Name *
Relationship to student *
Street Address *
Apartment Number
City *
Required
State *
Required
Zip Code *
Primary Phone Number *
Cell Number *
Work Number *
place NA if not applicable
Email Address *
2. Parent or Guardian First Name
Parent or Guardian Last Name
Relationship
Street Address
Apartment Number
City
State
Zip Code
Cell Number
Email Address
Work number
EMERGENCY CONTACTS
If the two adults listed above cannot be reached, only the persons below have the permissions to pick up the student
Full Name *
Emergency Contact 1
Relationship to Student *
Phone *
Full Name *
Emergency Contact 2
Relationship to Student *
Phone *
How did you hear about the school *
Required
Signature, Date, and Certification of Accuracy
* ARE agrees that the data/information provided in the Student Enrollment Form remain confidential and shall only be used for legitimate ARE business.
I confirm all the information provided above is correct to the best of my knowledge. I understand I understand that providing false information is punishable by law. *
Typed name acts as the signature of the Parent/Guardian with whom the student lives
Person Completing This Form Is: *
Submission Date *
MM
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Submit
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