2021-2022 Emerson Enrollment Application
Emerson School Enrollment Application
Email address *
Student Last Name *
Student First Name *
Gender *
Birthdate *
Must be 5 years of age by 9/1/21 for KG admission
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Grade Entering In September *
Primary Street Address *
Street Address and Apt/Unit, if applicable
Primary Zip Code *
Parent 1 *
First and Last Name
Parent 1 Email *
If you are placed on our waiting list we will most likely be contacting you over the summer or during the school year. Keep us informed of any changes to your phone numbers or email addresses during that time.
Parent 1 Phone (only digits, no dashes or spaces) *
If you are placed on our waiting list we will most likely be contacting you over the summer or during the school year. Keep us informed of any changes to your phone numbers or email addresses during that time.
Parent 2
First and Last Name
Parent 2 Email
Parent 2 Phone (only digits, no dashes or spaces)
Secondary Address (if applicable)
Street Address, Apt/Unit, and Zip Code
Who Does The Child Live With? *
My Child Lives Within The Portland School District *
Portland Neighborhood School *
Please choose 'None' if you live outside The Portland Public School District. To find your child’s school go to: http://www.pps.k12.or.us/departments/enrollment-transfer/6478.htm.
Outside Portland School District School
Name of School District and Name of School
My Child Is Currently Enrolled In... *
Child's Current School *
Are There Sibling Applying To The Emerson School *
List Sibling Name(s) And Grade(S)
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