Student Enrollment Form
Please fill in required information and changes only.

We would appreciate having your updated e-mail address.
Student Last_Name *
Your answer
Student First_Name *
Your answer
Student Middle_Name *
Middle Initial is all that is required.
Your answer
Student DOB *
MM
/
DD
/
YYYY
Grade Level
SSN
Your answer
Student Gender *
Student Home_Phone *
Your answer
GuardianEmail
E-mail address you would like the majority of communication to go to.
Your answer
Street *
Your answer
City *
Your answer
State *
Your answer
Zip *
Your answer
Father *
(Last, First)
Your answer
Father's Workplace
Your answer
Father's Work Phone
Your answer
Father's Cell Phone
Your answer
Mother *
(Last, First)
Your answer
Mother's Workplace
Your answer
Mother's Work Phone
Your answer
Mother's Cell Phone
Your answer
Who does the child live with? *
Who has custody? *
Emerg_Contact_1 *
(Last, First Name)
Your answer
Emerg_Phone_1 *
Please include area code and number.
Your answer
Emerg_Contact_2
(Last, First Name)
Your answer
Emerg_Phone_2
Please include area code and number.
Your answer
Allergies *
(If None, use N/A)
Your answer
Please add additional information necessary.
Your answer
Submit
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This form was created inside of Gratiot-Isabella Schools.