Moore County Schools Student Registration Form 2020-2021
Please complete this form to register your child for the 2020-2021 school year.
Student's Legal Name (First Middle Last) *
Your answer
Social Security #
Your answer
Date of Birth *
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City of Birth, State of Birth *
Your answer
Name of primary parent/guardian with whom the student lives *
Your answer
Address of primary parent/guardian with whom the student lives *
Your answer
Cell phone number of primary parent/guardian with whom the student lives *
Your answer
Email address of primary parent/guardian with whom the student lives
Your answer
Name of secondary parent/guardian
Your answer
Address of secondary parent/guardian
Your answer
Cell phone number of secondary parent/guardian
Your answer
Full Name of Mother
Your answer
Mother's Maiden Name
Your answer
Home Phone
Your answer
Cell Phone
Your answer
Place of Employment
Your answer
Work Phone
Your answer
Full Name of Father *
Your answer
Home Phone
Your answer
Cell Phone
Your answer
Place of Employment
Your answer
Work Phone
Your answer
The school sends Remind alerts for school events and closures. What phone number would you like to be contacted? *
Your answer
Grade student is enrolling in for the 2020-2021 school year. *
Year student entered 9th grade (if enrolling at MCHS)
Your answer
Enrollment *
Gender *
Ethnicity *
Are there any siblings of the student enrolled in Moore County Schools? *
If "yes" please list names and grades of siblings.
Your answer
Mode of Transportation (Check all that apply.) *
Required
If Bus Rider, AM Bus #
Your answer
If Bus Rider, PM Bus #
Your answer
Is either parent/guardian enlisted in the military? *
If "yes" please check which one.
Are there any custody issues of which we should be aware? *
Your answer
*If there are custody issues, please provide a copy of the court papers to the school within the first week of enrollment.
Name of emergency contact #1 (other than a parent) *
Your answer
Address and phone number for emergency contact #1 *
Your answer
Name of emergency contact #2 (other than a parent)
Your answer
Address and phone number for emergency contact #2
Your answer
Is English the student's primary language? *
If no, what language is spoken?
Your answer
Is the enrolling student a foster child? *
Is the enrolling student experiencing homelessness? *
Is the student covered under a Private Insurance Company or TennCare? Please list carrier. *
Your answer
Medical concerns for the enrolling student. *Include all food allergies.
Your answer
Name and address of last school attended
Your answer
Was the school last attended a public or private school?
Is the student currently suspended or expelled from another school? *
If yes, what is the last day of suspension?
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Is student currently participating in an alternative school program? *
The student has been enrolled in the following special programs (check all that apply):
Parent or guardian's name completing this form. *
Your answer
Today's Date *
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