W.O. Lance Pre-Registration Form
ALABAMA APPLICATION FOR STUDENT ENROLLMENT
Email address *
Must be completed by Parent/Legal Guardian
Today's Date *
MM
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DD
/
YYYY
Grade *
Student Last Name (As it appears on Birth Certificate) *
Student First Name (As it appears on Birth Certificate) *
Student Middle Name (As it appears on Birth Certificate) *
Student Date of Birth *
MM
/
DD
/
YYYY
Gender *
Contact Telephone Number *
Physical Address (Do NOT enter a PO Box) *
City *
Zip *
Mailing Address *
City *
Zip *
Student Lives With *
Disclosure of your child's Social Security Number (SSN) is voluntary. If you elect not to provide a SSN, a temporary number will be generated and utilized instead. Your child's SSN is being requested for use in conjunction with enrollment in a school as provided in Alabama Administrative Code $290-3-2-02(2)(b)(2). It will be used as a means of identification in the statewide student management system.
Social Security Number
Voluntary - Please enter the numbers in format XXX - XX - XXXX
PARENT(S)/GUARDIAN(S) - Verification shall be in accordance with local school board policy
Parent(s)/Guardian(s) #1 - Notify 1st (As it appears on Driver's License) *
Select One *
Address (If different than student)
Email Address *
Cell Phone *
Employer *
Work Phone *
Parent(s)/Guardian(s) #2 - Notify 2nd (As it appears on Driver's License) *
Select One *
Address (If different than student)
Email Address *
Cell Phone *
Employer *
Work Phone *
Special Information about Custody
Disclaimer
This is a Pre-Registration form only. You will receive additional information in your e-mall regarding the official online registration process for your student(s).
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