North Adams Public Schools Kindergarten Registration (Submit one form per student)

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PLEASE READ BEFORE CONTINUING:

CURRENT North Adams Public Schools Pre-K students DO NOT need to register for Kindergarten in the Fall.

If you have any questions, trouble with the form, or if it's more convenient for you to contact NAPS directly, please call Carrie Silva at 413-776-1673 or email csilva@napsk12.org.

*** PLEASE NOTE that new Kindergarten daycare waiver requests cannot be approved until mid-August. ***

Email *

Has this student ever attended one of the North Adams Public Schools PreK or Kindergarten classes in the past? (Head Start is not considered part of NAPS PreK) *

Yes

If you answered YES, what school, and when? (Skip if you answered NO)

Was this student previously enrolled in Kindergarten in a different school district and transferring to North Adams? If YES, please list the full name and address of that school here.

EARLY CHILDHOOD EDUCATION EXPERIENCE: Please mark ONE box next to the option that best describes your child's preschool experience in the school year PRIOR to entering Kindergarten. Please read each one CAREFULLY, as some reflect more than one program option and different number of hours. *

My child did not have any formal early childhood education program experience (was at home with parent(s) or was cared for by another family member/friend)

My child did not have any formal early childhood education program experience, but participated in Coordinated Family and Community Engagement (locally based parent/child playgroups, parent/child activities)

My child did not have any formal early childhood education program experience, but participated in Parent/Child Home Program Services (Home visiting program funded through the Department of Early Education and Care)

My child did not have any formal early childhood education program experience, but participated in BOTH Coordinated Family and Community Engagement AND Parent/Child Home Program Services

My child was in a Licensed Family Home Child Care (EEC licensed child care in a group setting in a private home) for LESS than 20 hours per week

My child was in a Licensed Family Home Child Care (EEC licensed child care in a group setting in a private home) for 20 hours or more per week

My child attended a Center Based Program (care in a group setting including public and private preschools, Head Start, YMCA, Monument Square, other daycare centers and integrated public preschools) for LESS than 20 hours per week

My child attended BOTH a Licensed Family Home Child Care AND a Center Based Program for LESS than 20 hours per week combined

My child attended BOTH a Licensed Family Home Child Care AND a Center Based Program for 20 hours or more per week combined

If your child attended a Center Based program, please let us know which one.

Head Start

YMCA

Monument Square

Williamstown Community Preschool

Other

Clear selection

Will this student require bus transportation, or will someone be dropping off/picking up from school? *

Yes, we will need the bus

No, we do not need the bus - someone will provide transportation

If you answered YES to needing bus transportation, please provide the address where your child will be picked up and dropped off (must be the same address for both - we cannot pick up and drop off at 2 different places)

Student's FULL LAST Name *

Student's FULL FIRST Name *

Student's FULL MIDDLE Name (if no middle name please enter NMN) *

Student's Date of Birth *

YYYY

Gender *

Female

Male

Non-Binary

City or Town of Birth *

Student Ethnicity - Is this student Hispanic or Latino? *

Yes

Student Race: (Please check ALL that apply) *

Asian

American Indian or Alaskan Native

Black or African American

Native Hawaiian or Other Pacific Islander

White

Required

Primary Home Phone Number - PLEASE USE DASHES (xxx-xxx-xxxx) *

Physical Street Address *

City *

State *

Zip Code *

If you have a different MAILING address, please provide the street, city, state and zip code

Who does the student live with? Check the best answer, and then fill in the following parent contact information sections as applicable. (scroll down several places for Guardian information if student does not live with parents) *

Both Parents

Primarily or Only with Mother

Primarily or Only with Father

Legal Guardian (documentation will be required prior to enrollment)

Required

Parent 1 or Mother's Name (Last, First)

Parent 1 or Mother's Full Address (if different from Student)

Parent 1 or Mother's Home Phone Number - PLEASE USE DASHES (xxx-xxx-xxxx)

Parent 1 or Mother's Cell Phone Number - PLEASE USE DASHES (xxx-xxx-xxxx)

Parent 1 or Mother's Daytime/Work Phone Number - PLEASE USE DASHES (xxx-xxx-xxxx)

Parent 1 or Mother's Email Address

Parent 2 or Father's Name (Last, First)

Parent 2 or Father's Full Address (if different from Student)

Parent 2 or Father's Home Phone Number - PLEASE USE DASHES (xxx-xxx-xxxx)

Parent 2 or Father's Cell Phone Number - PLEASE USE DASHES (xxx-xxx-xxxx)

Parent 2 or Father's Daytime/Work Phone Number - PLEASE USE DASHES (xxx-xxx-xxxx)

Parent 2 or Father's Email Address

If Student does not live with Parent(s), Name of Legal Guardian (Last, First)

Is this a foster care placement?

YES

Clear selection

Legal Guardian's Full Address

Legal Guardian's Home Phone Number - PLEASE USE DASHES (xxx-xxx-xxxx)

Legal Guardian's Cell Phone Number - PLEASE USE DASHES (xxx-xxx-xxxx)

Legal Guardian's Daytime/Work Phone Number - PLEASE USE DASHES (xxx-xxx-xxxx)

Legal Guardian's Email Address

Are there any custody issues we need to be aware of? If YES, please explain below. (Legal documentation will be required) *

Does Student have any siblings that CURRENTLY attend North Adams Public Schools? *

Yes

Required

If you answered YES, Please List Full Name(s) and Grade Level(s) of Sibling(s) who CURRENTLY attend North Adams Public Schools, or who you will be enrolling in addition to this student.

Please provide full names, phone numbers and relationship to this student, of AT LEAST 2 other Emergency Contacts - OTHER THAN PARENT(S)/GUARDIAN(S) - that the school may call if not able to contact you in an emergency to pick up your child. *

Academic Information: Please check ALL applicable boxes below, and be prepared to provide copies, if noted. *

Student is on an Individual Educational Plan (IEP) or receiving Special Education Services. (Please provide a copy)

Student is on a 504 plan. (Please provide a copy)

Student receives Counseling Services.

Student currently receives English Language Services (ELL).

NONE OF THE ABOVE

Required

Is this student involved with any other outside agencies? If YES, explain below.

Are there any behavioral concerns that may affect school progress? If YES, explain below.

Does your child have any allergies that the school needs to know about? (Foods, Latex, Insects, etc?)

NOTICE OF POSSIBLE PUBLICATION OF STUDENT INFORMATION: Do you give consent for your child's information to be publicized (such as awards, honors, school celebrations, etc. in the form of photos or written publications)? If you choose NO, you must provide the school with a written letter stating such, and NO information will be publicized about your child. If you choose YES, you are also (by law) consenting to Section 9528 (Armed Forces Recruiter Access to Students and Student Recruiting Information on the No Child Left Behind Act) which requires schools receiving assistance under the Elementary and Secondary Education Act of 1965 to provide students' names, addresses and telephone numbers to military recruiters when age required. *

Yes

No (You must also submit a written letter to the school)

MILITARY FAMILY STATUS (In compliance with the Massachusetts Valor Act) Please check all that apply. Is this student a child of: *

An active duty member of the uniformed services or National Guard member on active duty?

A service member who was medically discharged or retired within THE PAST YEAR?

A service member who died while on active duty?

NONE OF THE ABOVE

Required

There are some additional documents we will need to complete enrollment, and you will be contacted for those separately. Do you have the ability to take a clear picture or scan/copy and email these documents to the school district? (Such as proof of residency documents, birth certificates, etc?) If you do not, other arrangements for submitting these documents will be made. *

Yes

By typing my name below, I certify that the responses provided are accurate and complete as specified by Massachusetts General Law. I understand that failure to disclose or to misrepresent any of the required information may result in my student's exclusion from North Adams Public Schools. I have read and understand the registration and residency requirements of North Adams Public Schools and I am aware that it is my obligation to inform my child's school if there is a change in the residency of my family or guardianship of my child. *

Relationship to child *

Send me a copy of my responses.

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