Weston Elementary BK-2 Registration Form

BK-2 Registration Form

Fill out the form carefully for registration
Student Name *

First Name Middle Name Last Name
Gender *
Grade *
Date of Birth *

Month Day Year
Birthplace *
Special Education *
Speech *
*If yes to either special education or speech question, stop here and contact the CEC at 810-724-9853. Please attach most current IEP.
Attach current IEP

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Cancel of
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
County of Residence *
Home Phone *

Area Code Phone Number
Cell Phone *

Area Code Phone Number
Please list any health considerations, allergies, or medications: *
Ethnicity: is this student (or are you) Hispanic/Latino? *

No, not Hispanic/Latino Yes, Hispanic/Latino
Race *
Parent and/or Guardian Information
Father/Guardian Name *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Marital Status *
Employer Name/Occupation *
Work Phone *

Area Code Phone Number
Cell Phone *

Area Code Phone Number
Active Military *

Yes No
Email address *
example@example.com
Mother/Guardian Name *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Marital Status *
Employer Name/Occupation *
Work Phone *

Area Code Phone Number
Cell Phone *

Area Code Phone Number
Active Military *

Yes No
Email address *
example@example.com
Non-Custodial Parent Information

Court documentation must be provided and included in your child's school record if non-custodial parent cannot pick up student from school.
Non-Custodial Parent Name:

First Name Last Name
Who has legal Custody?
Cell Phone Number

Area Code Phone Number
Work Phone Number

Area Code Phone Number
Is student allowed to leave with non-custodial parent?

Yes No
Emergency Contacts (other than parents/guardians)
Family Information
Brothers
Sisters
Other Student Information
Last School Attended: *
Date Left: *
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Comments and/or additional information:
Presently, is your family living in any of the following situations? Check one box: *

Staying in a shelter, temporary trailer, or waiting for foster care placement Doubled up-sharing the housing with others/relatives due to loss of housing, economic hardship or similar reason Living in a motel or hotel due to loss of housing, economic hardship or similar reason Living in a motel or hotel due to loss of housing, economic hardship or similar reason Moving from place to place Living with an adult that is not a parent or legal guardian None of the above
Kindergarten Readiness Assessment 2020
What was your child’s primary form of care this year (2019-2020), the year before entering kindergarten or early 5’s/ begindergarten? (check all that apply) *

Great Start Readiness Program (GSRP) Head Start Family/Relative Care Child Care- Home based Tuition-based Preschool Early Childhood Special Education Classroom Early 5's /Begindergarten/Developmental Kindergarten Child Care- Center No Prior Care/Program
Name of school or facility that your child attended school or childcare: *
What was the schedule of your child’s primary form of care last year? *

Part-day Full-day
How many days per week? *

5 days per week 4 days per week
How long did your child attend? *

Entire School Year Half of a year
Please sign and date the Registration Form below:
Parent/Guardian Signature *

Clear
Date *

Month Day Year
Date
Should be Empty:

BK-2 Registration Form

*If yes to either special education or speech question, stop here and contact the CEC at 810-724-9853. Please attach most current IEP.

Parent and/or Guardian Information

Non-Custodial Parent Information

Emergency Contacts (other than parents/guardians)

Family Information

Other Student Information

Kindergarten Readiness Assessment 2020

Please sign and date the Registration Form below: