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) *
Social Security #
Date of Birth *
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City of Birth, State of Birth *
Name of primary parent/guardian with whom the student lives *
Address of primary parent/guardian with whom the student lives *
Cell phone number of primary parent/guardian with whom the student lives *
Email address of primary parent/guardian with whom the student lives
Name of secondary parent/guardian
Address of secondary parent/guardian
Cell phone number of secondary parent/guardian
Full Name of Mother
Mother's Maiden Name
Home Phone
Cell Phone
Place of Employment
Work Phone
Full Name of Father *
Home Phone
Cell Phone
Place of Employment
Work Phone
The school sends Remind alerts for school events and closures. What phone number would you like to be contacted? *
Grade student is enrolling in for the 2020-2021 school year. *
Year student entered 9th grade (if enrolling at MCHS)
Enrollment *
Gender *
Ethnicity *
Are there any siblings of the student enrolled in Moore County Schools? *
If "yes" please list names and grades of siblings.
Mode of Transportation (Check all that apply.) *
Required
If Bus Rider, AM Bus #
If Bus Rider, PM Bus #
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? *
*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) *
Address and phone number for emergency contact #1 *
Name of emergency contact #2 (other than a parent)
Address and phone number for emergency contact #2
Is English the student's primary language? *
If no, what language is spoken?
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. *
Medical concerns for the enrolling student. *Include all food allergies.
Name and address of last school attended
Was the school last attended a public or private school?
Clear selection
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. *
Today's Date *
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