Student Information
Registration for Ford Heights School District 169, School Year 2021-2022
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Student State ID Number (To be completed by the school)
School *
Student Name (First, Middle, Last) *
Student Grade (registering for) *
Student Date of Birth *
MM
/
DD
/
YYYY
Parent Email *
Mother's Name (Last, First) *
Mother's Maiden Name *
Father's Name (Last, First) *
Street Address *
City *
State *
Zip Code *
Home Phone (xxx) xxx-xxxx *
Parent's Social Security xxx-xx-xxxx *
LIST ALL SIBLINGS IN THE HOUSEHOLD BELOW
Sibling 1 (Last, First, Middle, D.O.B, Grade)
Sibling 2 (Last, First, Middle, D.O.B, Grade)
Sibling 3 (Last, First, Middle, D.O.B, Grade)
Sibling 4 (Last, First, Middle, D.O.B, Grade)
Sibling 5 (Last, First, Middle, D.O.B, Grade)
Sibling 6 (Last, First, Middle, D.O.B, Grade)
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