Waukomis High/Middle School Online Enrollment Packet
Please fill out all information requested completely and accurately. Thank you!
General Information
In an effort to reduce the amount of time it takes for our parents to complete enrollment forms, we have created an online enrollment packet. At the completion of filling out the online packet, the parent will still be required to physically sign off on a checklist that also acknowledges that you completed accurately and understood all terms included in the enrollment packet. New student enrollment will also still be required to submit necessary paperwork including copies of birth certificate, shot records, social security card, and proof of residence.
Child First Name *
Your answer
Child Middle Name *
Your answer
Child Last Name *
Your answer
Date of Birth *
(MM/DD/YYYY)
Your answer
Birthplace City State *
Your answer
Returning Student? *
Required
Mailing Address *
Your answer
Home Street Address *
Your answer
City State Zip *
Your answer
Is your student homeless? *
Gender *
Student Cell Phone
Your answer
Ethnic Group *
Hispanic Latino *
US Citizen *
Last School Attended *
Your answer
Grade Entering *
Does your child receive special educaiton services? *
Is a language other than English used in the home? *
If Yes, what is that language
Your answer
If Yes, is that other language spoken in the home
Student resides with *
Are there Legal/Custody Papers pertaining to this child? Please note, the school must have a copy of the court order on file declaring custody arrangement. *
Guardian 1 First Name
Your answer
Guardian 1 Last Name
Your answer
Guardian 1 Home Phone Number
Your answer
Student Access Information *
Required
Guardian 1 Cell Phone Number
Your answer
Guardian 1 Mailing Address
Your answer
Guardian 1 City, State, Zip Code
Your answer
Guardian 1 E-Mail Address
Your answer
Guardian 1 Place Of Employment
Your answer
Guardian 1 Work Phone Number
Your answer
Guardian 2 First Name
Your answer
Guardian 2 Last Name
Your answer
Guardian 2 Home Phone Number
Your answer
Student Access Information *
Required
Guardian 2 Cell Phone Number
Your answer
Guardian 2 Mailing Address
Your answer
Guardian 2 City, State, Zip
Your answer
Guardian 2 E-Mail Address
Your answer
Guardian 2 Place Of Employment
Your answer
Guardian 2 Work Phone Number
Your answer
Step Mother First Name
Your answer
Step Mother Last Name
Your answer
Step Mother Home Phone Number
Your answer
Student Access Information
Step Mother Cell Phone Number
Your answer
Step Mother Mailing Address
Your answer
Step Mother City, State, Zip
Your answer
Step Mother E-mail
Your answer
Step Mother Place Of Employment
Your answer
Step Mother Work Phone Number
Your answer
Step Dad First Name
Your answer
Step Dad Last Name
Your answer
Step Dad Home Phone Number
Your answer
Student Access Information
Step Dad Cell Phone Number
Your answer
Step Dad Mailing Address
Your answer
Step Dad City, State, Zip
Your answer
Step Dad E-mail
Your answer
Step Dad Place Of Employment
Your answer
Step Dad Work Phone Number
Your answer
Emergency Contact First Name (Other than parents) *
Your answer
Emergency Contact Last Name *
Your answer
Emergency Contact Phone Number *
Your answer
Emergency Contact Relationship To Child *
Your answer
Is your student Diabetic *
Is you student Asthmatic *
Does your child carry an inhaler with them?
Please list any important medical information and/or food allergies for student:
Your answer
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