Teton School District 401
Student Enrollment Form for students who were NOT ENROLLED in a Teton School District school last year.
Today's Date *
MM
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DD
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YYYY
Student's LEGAL Name (Last, First, Middle) *
Your answer
Grade Level (If it is summer - the grade in which they are enrolling at the beginning of the school year) *
Your answer
Date of Birth *
MM
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DD
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YYYY
Has the student ever attended Teton School District 401 (but not the previous year)? *
What grades did the student attend here in the district? (Check all that apply)
Place of Birth *
Your answer
1st Language *
Your answer
2nd Language *
Your answer
Is your primary home language English? *
Type of Registration (click all that apply) *
Required
Last School Attended (If applicable) *
Your answer
City *
Your answer
State *
Your answer
My student has the following special student needs (check all that apply): *
Required
Primary Household
Household Phone *
Your answer
Student Cell Phone *
Your answer
Residence Address (number, street, and apt #) *
Your answer
City *
Your answer
State *
Your answer
Zip code *
Your answer
Mailing Address if different (P.O. Box, etc.) *
Your answer
City *
Your answer
State *
Your answer
Zip code *
Your answer
Parent/Guardian Info (Living in this Household)
Parent/Guardian - Last, First, Middle *
Your answer
Relationship to Student *
Your answer
Cell Phone *
Your answer
Work Phone *
Your answer
Employer
Your answer
Email Address *
Your answer
Parent Notification options *
Required
2nd Parent/Guardian Info (living in the same household)
Parent/Guardian - Last, First, Middle *
Your answer
Relationship to Student *
Your answer
Cell Phone *
Your answer
Work Phone *
Your answer
Employer
Your answer
Email Address *
Your answer
Parent Notification options *
Required
Other District 401 Students (living in the same household)
Your answer
Primary Emergency Contacts
Emergency Contact Name (Last, First) *
Your answer
Emergency Contact Phone *
Your answer
Emergency Contact Address *
Your answer
Secondary Emergency Contact Name (Last, First) *
Your answer
Secondary Emergency Contact Phone *
Your answer
Secondary Emergency Contact Address *
Your answer
Custodial/Legal Information - if applicable
To assist us in complying with legal actions, please provide us with a copy of any appropriate legal documents (e.g. court orders, foster parent placement forms, or notarized temporary guardianship forms).
Custody Papers on file?
Custody
Non-custodial Parent
Student Health Information
For students who choose to participate in field trips, activities, assemblies, etc.
Student has had Vericella (Chicken pox) *
The student is immunized for Varicella (chicken pox)? *
Please list any health problems or special needs of the student:
Your answer
Allergies (hay fever, bee stings, food, medication, etc.)
Your answer
I give permission for my child to attend field trips. *
Attendance Policy - I have read and understand the attendance policy (Click to review) *
Internet Publishing Policy - I have read and understand the Internet Publishing policy. *
Photographs and/or Filming - I give permission for photographs and/or filming of my above named child by the news media or Teton School District #401 staff. *
Computer Use Agreement
Access to and use of Teton School District #401 network and computers is contingent on the user accepting the following terms and conditions: (see Computer Use Agreement on the website).
I accept these terms and conditions and understand that any violation of them may result in loss of privileges to access District networks and computers. In addition, any violation that is illegal or prohibited by the Student Code of Conduct will also result in disciplinary and/or legal action being taken. *
Google Applications and Student Accounts
Google Apps provides students with the following online tools: Google Docs (similar to Microsoft Office), Calendar, Sites (web page), and Mail (an internal email account that is monitored and filtered by Teton School District #401). Students accounts will not be used by Google for advertising. *
I have read over the Student Code of Conduct in the Handbook and I will abide by it: *
Pursuant to State and District Policy, the following documents are required for enrollment:
Proof of Immunization; Birth Certificate; Proof of Residency; Unofficial Transcript (Middle School only); Withdrawal/Checkout Grades if during the school year (Middle School only)
I understand the above and will bring a copy of the above as part of my enrollment. *
Acknowledgements and Permissions
As part of Teton Online School, students are not required to do the following, and can choose whether or not to participate.
Parent/Legal Guardian - By typing your name below you acknowledge that the above information is true and up to date and that you agree to the terms of enrollment. *
Your answer
Student - By typing your name below you acknowledge that the above information is true and up to date and that you agree to the terms of enrollment.
Your answer
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