Colusa Unified School District School Enrollment Form

Colusa Unified School District School Enrollment Form
Welcome to our online registration. Below is a list of documents you will need to enroll your child. If you have the documents electronically, you may attach them to this application. If you do not have the documents electronically, a staff member will schedule a time to obtain copies.
To enroll your child, please provide the following:
- Verification of Birth (any of the following will be accepted): Passport, Birth Certificate, Baptismal Certificate, Parent/Guardian/Caregiver's Affidavit.
- Student’s immunization record ( see link for CA requirements ).
- Proof of Residency – Please provide one of the following original documents dated within the last 3 months.
  - Property tax payment receipt
  - Signed rental property contract or lease or rent payment receipt
  - Utility Service contract, statement or payment receipt
- Copy of current IEP for Special Education Students (if applicable)
- Copy of current 504 plan (if applicable)
- Report of health exam (required prior to entering first grade).
- Oral Health Assessment form (required prior to entering first grade).
- A photocopy of previous IEP for Special Education students only.
- A photocopy of previous 504 Plan, if applicable.
- Checkout sheet with grades from previous school (grades 7-12 only).
- Last report card from previous school (grades 7-8 only).
- Transcript from previous school (grades 9-12 only).
Also, if the student is a non-resident, provide any and all that apply (Non-Resident Entry):
- Caregiver Letter (must also provide one of the documents listed under Proof of Residency).
- Foster Care (must provide Foster Care documents and one of the documents listed under Proof of Residence).
- Interdistrict Transfer
- Affidavit of Non-Permanent Residence
For questions about enrollment, please contact Colusa Unified School District at (530) 458-7791 option 6 and leave a message if no one answers. Email: cusdpasswords@colusa.k12.ca.us

Colusa Unified School District Enrollment

Legal name of student as identified on Birth Certificate (Court documents are required for a legal name change).
Student's Full Name *

First Name Middle Name Last Name
Student's Home Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Is the student's mailing address different than home address? *

Same as Home Address Different than Home Address
Student's Mailing Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Student Email Address
example@example.com
Student Cell Phone

Area Code Phone Number
Household Primary Phone Number *

Area Code Phone Number

Sibling Information (Siblings Living in the Same Household as this Student):
Sibling #1
Sibling #1 Name

First Name Last Name
Sibling #1 Birthday

Month Day Year
Date
Sibling #1 Age
Sibling #1 Current School
Sibling #2
Sibling #2 Name

First Name Last Name
Sibling #2 Birthday

Month Day Year
Date
Sibling #2 Age
Sibling #2 Current School
Sibling #3
Sibling #3 Name

First Name Last Name
Sibling #3 Birthday

Month Day Year
Date
Sibling #3 Age
Sibling #3 Current School

Previous School Attended
Is your Child Enrolling in Kindergarten? *

Yes No
Recent/Current School
Name of District
Last Grade Level
Has the student ever been retained?

Yes No
If yes, what grade level?
Has your student ever been expelled?

Yes No
Is your student currently suspended or expelled from another school?

Yes No
If yes, please provide name of school:

I hereby attest that all information supplied on this form is true and correct to the best of my knowledge. Additionally, I hereby authorize the release of my student's records (including health, behavioral, attendance, Special Education / 504, and academic) from any school in which they previously attended.
Last School Attended *
School District *
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number *

Area Code Phone Number
Parent / Guardian Signature *

Clear
Parent Guardian Name *

First Name Last Name
Date *

Month Day Year
Date
Please upload any and all of the required documents.

Browse Files
You can upload multiple files by holding down the ctrl key (cmd key on a mac) and then selecting the documents. Cancel of
Should be Empty:

Colusa Unified School District School Enrollment Form

Colusa Unified School District Enrollment

Student Information Continued

Parent/Legal Guardian Information

PARENT/LEGAL GUARDIAN #1

Parent/Legal Guardian #2

Emergency Contact

Emergency Contact #1

Emergency Contact #2

Sibling Information (Siblings Living in the Same Household as this Student):

Sibling #1

Sibling #2

Sibling #3

Local Educational Agency Name Housing Questionnaire

Programmatic Information and Authorization

Previous School Attended

Student Emergency & Health Information

The State of California Required the Following Immunizations:

Health History

Vision

Hearing