Bellaire Elementary Kindergarten Registration 2022-2023

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Students must be 5 years old on or before August 1

Screening appointments will be scheduled between May 23-25. You will need to bring the following to screening:

-child
-child's birth certificate
-immunization/vaccination records
-proof of residency
-any court documents concerning custody of the child, if applicable

Call 740-676-1272 will any questions

Student's Name *

Gender of Student *

Male

Female

Address *

Student Birthdate *

Birth City *

Ethnicity *

Language *

Phone number *

Email Address *

Names of siblings in the district (type none, if none) *

Mother/Guardian Name *

Mother Maiden Name *

Phone number *

Father's Name

Phone number

What is the students current living situation? *

Single family home

Shared housing with other family members, families or individuals because of loss of housing, economic hardship or other similar situation

Shelter or temporary housing

Car, park, public space, campground, etc.

Hotel or motel

Other:

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