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  • 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).
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  • Student Information Continued

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  • HOME LANGUAGE: The California Education Code requires schools to determine the languages spoken at home by each student. This information is essential in order to provide meaningful instruction for all students.

  • Parent/Legal Guardian Information

    Parent/Legal Guardian Information (REQUIRED - If you need to include more than two legal guardians, please contact the school.)

  • PARENT/LEGAL GUARDIAN #1

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  • Parent/Legal Guardian #2

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  • Emergency Contact

    Emergency Contact Information: Please notify the school if any of the individuals below require access to attendance, grades and discipline information.

  • Emergency Contact #1

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  • Emergency Contact #2

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

  • Sibling #1

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  • Sibling #2

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  • Sibling #3

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  • Local Educational Agency Name Housing Questionnaire

    California Department of Education March 2020

  • The information provided below will help the LEA determine what services you and/or your child may be eligible to receive. This could include additional educational services through Title I, Part A and/or the federal McKinney-Vento Assistance Act. The information provided on this form will be kept confidential and only shared with appropriate school district and site staff.

  • The undersigned parent/guardian certifies that the information provided above is correct and accurate.

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  • Your child or children may have the right to:
    Immediate enrollment in the school they last attended (school of origin) or the local school where you are currently staying, even if you do not have all the documents normally required at the time of enrollment.
    Continue to attend their school of origin, if requested by you and it is in the best interest.
    Receive transportation to and from their school of origin, the same special programs and services, if needed, as provided to all other children, including free meals and Title I.
    Receive the full protections and services provided under all federal and state laws, as it relates to homeless children, youth, and their families.

    If you have any questions about these rights, please contact the local homeless liaison, Lori Tanner, by phone at (530) 458-5853 or by email at ltanner@colusa.k12.ca.us

  • Programmatic Information and Authorization


  • Previous School Attended

  • Student Emergency & Health Information

    In the event of an accident, or other emergency, when a parent or guardian is unavailable, a representative of the school will make arrangements as he / she considers necessary for the child to receive medical hospital care, including necessary transportation, in accordance with their best judgement. Such care and treatment will be performed by a licensed health professional.

  • The State of California Required the Following Immunizations:

    Polio - 4 doses at any age; however, 3 doses meet requirements for ages 4-6 if at least one was given within 4 days of or after the 4th birthday; 3 doses meet the requirement for ages 7-17 if at least one was given within 4 days of or after the 2nd birthday.
     
    Diphtheria, Tetanus and Pertussis (DTaP) - at least 4 doses (DTP, or a combination of a DTaP and diphtheria - tetanus toxoids). The last doe must be on or after a child's 4th birthday, this meets the requirements for ages 4-6; the last dose must be given on or after the child's 2nd birthday, this meets the requirements for ages 7-17.
     
    Tdap Booster - Required for 7th grade. 1 dose on or after the 7th birthday meets requirements.
     
    Measles, Mumps, and Rubella - 2 doses required for ages 4-6, 2 doses required for 7th grade, or 1 dose required for ages 7-17 - all doses must be on or after a child's 1st birthday.
     
    Hepatitis B - at least 3 doses required for ages 4-6 - this series must have begun and be on schedule for completion. Varicella (Chickenpox) - 1 dose required for ages 4-6, 1 dose required for ages 7-12, or 2 doses required for ages 13-17, or documentation of the disease by a physician.

  • Health History


  • Vision

  • Hearing

  • A current signed PHYSICIAN AUTHORIZATION FOR MEDICATION IN SCHOOL form must be on file in the office for any student taking medications (prescribed by a physician or over the counter, during school hours). THIS FORM MUST BE RENEWED YEARLY.


  • ** Conditions require a Healthcare Plan. Any above condition may require a Healthcare Plan. All forms may be obtained in the school office.
     
    California Education Code 49423 and 49402: The parent or legal guardian of students taking medication on a regular schedule shall notify the school nurse or other designated school employee of the medication. If at any time your child is ill or has a condition that you feel requires being excused from physical education for more than five (5) days, a written explanation is required from your child's physician.

  • 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.

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