Parent Portal Registration Form

	A	B	C	D	E	F
1	FORT ZUMWALT SCHOOL DISTRICT
2	Parent Web-Access Registration Form
3
4	For security purposes, you must return this completed form to your child's school in person. You will be asked to
5	show a photo ID when you register. One parent/guardian (in person) may register additional parents/guardians.
6	Up to four parent/guardian logins may have access to a student's information. Once you are registered, the
7	information will be put into our district's student management system at your child's school.
8	The Parent Web-Access system will then email the registered email address(es) the login password. Your login user
9	name will be your registered email address. To logon to the parent portal, go to the district website at:
10	www.fz.k12.mo.us and click on PARENTS, STUDENTS, ALUMNI > Parents > Log-in to the Portal
11	PLEASE BE SURE TO CLEARLY PRINT ALL INFORMATION BELOW.
12
13	Please check the Appropriate Item(s):
14	_____I am registering for the first time.
15	_____Update my information in Parent-Web Access (i.e. new mail account)
16	_____Add another user to my existing Web Access account
17	_____Reset my login password
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19
20	(PLEASE PRINT ALL INFORMATION)
21	Household Parent 1 First and Last Name:
22	E-mail Address:
23	Household Parent 2 First and Last Name:
24	E-mail Address:
25	Nonresident Parent 1 First and Last Name:
26	E-mail Address:
27	Nonresident Parent 2 First and Last Name:
28	E-mail Address:
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30		Student 1	Student 2	Student 3	Student 4
31	Name of School
32	First Name
33	Last Name
34	Birthdate
35	Grade
36	Signature and Photo ID are required to register for Parent-Web Access
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38	Parent/Guardian Signature____________________________________________________Date_____________________
39
40	FOR OFFICE USE ONLY				School Routing
41		Building/Registrar Initials	Last 4-digits of ID#	Date	From	To
42	Identification Verified
43	Entered into SIS
44						Revised 6/21/17