2026-2027 Student Information Form

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Email *

Student's Full Name *

Birthdate *

YYYY

Gender *

Male

Female

Grade *

Kindergarten

1st

2nd

3rd

Hispanic or Latino ethnicity *

Yes

Race *

American Indian or Alaska Native (A person having origins in any of the original peoples of North and South America, including Central America, and who maintains tribal affiliation or community attachment.)

Asian (A person having orgins in any of the orginal peoples of Far East, Southeast Asia, or the Indian subcontinent, including for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam)

Black or African American (A person having origins in any of the black racial groups of Africa)

Native Hawaiian or Other Pacific Islander (A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands)

White (A person having origins in any of the original peoples of Europe, Middle East, or North America)

Other:

Language Spoken at Home *

Student Physical/911 Address *

Student Mailing Address *

Student Phone Number *

Parent/Guardian #1 Name *

Parent/Guardian #1 Relationship to Student *

Parent/Guardian #1 Language of Correspondence *

Parent/Guardian #1 Mailing Address *

Parent/Guardian #1 email address *

Parent/Guardian #1 Phone number *

Parent/Guardian #1 Employer *

Does student primarily reside with Parent/Guardian #1? *

Yes

Parent/Guardian #2 Name *

Parent/Guardian #2 Relationship to student *

Parent/Guardian #2 Language of correspondence *

Parent/Guardian #2 Mailing address *

Parent/Guardian #2 email *

Parent/Guardian #2 Phone Number *

Parent/Guardian #2 Employer *

Does student primarily reside with Parent/Guardian #2? *

Yes

Additional Guardian contact name

Additional Guardian contact relationship to student *

Additional Guardian contact language of correspondence

Additional Guardian contact mailing address

Additional Guardian contact email

Additional Guardian contact employer

Does the student primarily reside with additional guardian *

Yes

Emergency Information

Contacts other than guardians to be called in case of an emergency

Emergency Contact #1 Name *

Emergency Contact #1 Relationship *

Emergency Contact #1 Number *

Emergency Contact #2 Name *

Emergency Contact #2 Relationship *

Emergency Contact #2 Number *

Emergency Contact #3 Name *

Emergency Contact #3 Relationship *

Emergency Contact #3 Number *

Parent/Guardian digital Signature *

Today's Date *

YYYY

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