Waukomis Elementary 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 and State *
Your answer
Returning Student? *
Required
Mailing Address *
Your answer
Home Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Is your student homeless? *
Gender *
Ethnic Group *
Required
Hispanic Latino *
US Citizen *
Last School Attended *
Your answer
Grade Entering *
Does your child receive special education services? *
Does your child receive speech services? *
Has your student ever been in Gifted and Talented classes? *
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
Guardian 1 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
Guardian 2 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
Step-Mother Student Access Information
Step-Mother Cell Phone Number
Your answer
Step-Mother Mailing Address
Step-Mother Place of Employment
Your answer
Step-Mother Work Phone Number
Your answer
Step-Father First Name
Your answer
Step-Father Last Name
Your answer
Step-Father Home Phone Number
Your answer
Step-Father Student Access Information
Step-Father Cell Phone Number
Your answer
Step-Father Mailing Address
Step-Father Place of Employment
Your answer
Step-Father Work Phone Number
Your answer
Emergency Contact First Name (Other than parents) *
Your answer
Emergency Contact Last Name *
Your answer
Emergency Contact Student Access Information
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
Has you child ever been retained in school? *
If you child has been retained, please list the grade(s).
Your answer
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