Pond Creek-Hunter Elementary Online Enrollment Packet
Please fill out all information requested completely and accurately. Thank you!
Name of Person Completing Form *
Relationship to Child *
Child Legal First Name *
Child Legal Middle Name
Child Legal Last Name *
Child Preferred Name or Nickname
SSN
Date of Birth *
(MM/DD/YYYY)
Birthplace City State *
Mailing Address *
Home Street Address *
City State Zip *
Gender *
Ethnic Group *
If 2 or More Races, Please Specify Which Races
US Citizen *
Last School Attended *
Last Grade Completed *
Grade Entering *
Is a language other than English used in the home? *
If Yes, what is that language
If Yes, is that other language spoken in the home
Clear selection
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 *
Guardian 1 Last Name *
Guardian 1 Home Phone Number *
Guardian 1 Cell Phone Number *
Guardian 1 Mailing Address *
Guardian 1 City, State, Zip Code *
Guardian 1 E-Mail Address *
Guardian 1 Place Of Employment *
Guardian 1 Work Phone Number *
Guardian 2 First Name *
Guardian 2 Last Name *
Guardian 2 Home Phone Number *
Guardian 2 Cell Phone Number *
Guardian 2 Mailing Address *
Guardian 2 City, State, Zip *
Guardian 2 E-Mail Address *
Guardian 2 Place Of Employment *
Guardian 2 Work Phone Number *
Emergency Contact 1 (other than Parent/Guardian) First & Last Name *
Emergency Contact 1 Phone Number *
Emergency Contact 1 Relationship to Child *
Emergency Contact 2 (other than Parent/Guardian) First & Last Name
Emergency Contact 2 Phone Number
Emergency Contact 2 Relationship to Child
Please list any important medical information and/or food allergies for student. *Note: A doctor's note is required for all food allergies. Please turn in to the appropriate office.
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