Student Enrollment Form – Middleton Heights Elementary
Additional student information will need to be collected/filled out at individual schools for each child entering Middleton School District.
Demographic Information
Student’s Legal Last Name *
Student’s Legal First Name *
Student’s Legal Middle Name *
Preferred Name
Grade *
Gender *
Birth Date *
MM
/
DD
/
YYYY
Place of Birth (City) *
Place of Birth (State) *
Place of Birth (Country) *
Ethnicity *
Race *
Required
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