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Child Information

Name

< Last Name

< First Name

< Middle Name

< Preferred Name

Basic Information

< Gender

< Applying for Grade

< Birthdate

Address

< Home Address

< City

< State

< Zip

< Home Telephone

Ethnicity and Language

< Ethnicity (optional)

< Primary Language

< Other(s) Spoken

School

< Current School

< School Address

< School City

< School State

< School Zip

< School Telephone

Please list schools previously attended by the child and dates of attendance.

Siblings

Please list other children in the family, including their birthdates and current schools.

Parent/Guardian Information

< Number of Parents/Guardians for Child

Select number of parents to show information fields for each parent.

Parent 1 Information

Same address as child   Different address

< Parent 1 Last Name

< First Name

< Home Address

< City

< State

< Zip

< Home Telephone

< Mobile

< Email

< Primary Language

< Occupation

< Employer

< Business Telephone

Legal custodian of child? Yes   No

Parent 2 Information

Same address as child   Different address

< Parent 2 Last Name

< First Name

< Home Address

< City

< State

< Zip

< Home Telephone

< Mobile

< Email

< Primary Language

< Occupation

< Employer

< Business Telephone

Legal custodian of child? Yes   No

Parent 3 Information

Same address as child   Different address

< Parent 3 Last Name

< First Name

< Home Address

< City

< State

< Zip

< Home Telephone

< Mobile

< Email

< Primary Language

< Occupation

< Employer

< Business Telephone

Legal custodian of child? Yes   No

Parent 4 Information

Same address as child   Different address

< Parent 4 Last Name

< First Name

< Home Address

< City

< State

< Zip

< Home Telephone

< Mobile

< Email

< Primary Language

< Occupation

< Employer

< Business Telephone

Legal custodian of child? Yes   No

Person Financially Responsible

Same address as child   Different address

< Name

< Billing Address

< Billing City

< Billing State

< Billing Zip

< Billing Telephone