High School Student Enrollment
Wewoka Public Schools
Name
*
First Name
Middle Name
Last Name
Social Security Number
*
xxx-xx-xxxx
Gender
*
Male
Female
Date of Birth
*
-
Month
-
Day
Year
Date
Birth Place (City, State)
Birth Certificate
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Grade
*
Please Select
9th
10th
11th
12th
Educational Model
*
Traditional
Virtual (Interview required with Mrs. Nikki Azlin)
Immunization Record 4 Year Old Program/Pre-K (Required by state of Oklahoma)
4 Doses DTP/DTap
3 Doses Polio
1 Dose MMR
3 Doses HEP B
2 Doses HEP A
1 Dose Varicella
Immunization Record Kindergarten through 6th Grade
5 Doses DTP/DTaP
4 Doses Polio
2 Doses MMR
Immunization Record 7th through 12th
1 TDap Booster
Shot Records
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Address of Residence
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Transportation Info
Please Select
Car Rider
Parent Pick-Up
Walker
Bus Rider
Day Care
If Daycare, which one?
Race
African American
Caucasian
Asian
Native American
Other
Does this student have any degree of American indian Ancestry or have a CDIB Card?
*
Yes
No
CDIB Card (If Applicable)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Previous School Attended (If Applicable)
Date of Last Attendance (If Applicable)
-
Month
-
Day
Year
Date
Legal Guardian #1 Name
*
First Name
Last Name
Legal Guardian #1 Relationship to student
*
Legal Guardian #1 Social Security Number
*
xxx-xx-xxxx
Legal Guardian #1 Phone
*
Please enter a valid phone number.
Legal Guardian #1 Email
*
example@example.com
Legal Guardian #1 Place of Employment & Phone Number
Legal Guardian #2 Name
*
First Name
Last Name
Legal Guardian #2 Relationship to student
*
Legal Guardian #2 Social Security Number
*
xxx-xx-xxxx
Legal Guardian #2 Phone
*
Please enter a valid phone number.
Legal Guardian #2 Email
*
example@example.com
Legal Guardian #2 Place of Employment and Number
Emergency Contact #1
*
Emergency Contact #2
*
Non-Household Information: List in order of notification preference. Any contact listed, or created on the parent portal, may pick up a student or be contacted in case of illness/emergency, if parent(s)/guardians are unavailable.
*
School age siblings (Legal Name, Birthdate, Grade, Gender, and Building)
*
Vision Conditions
Contacts
Glasses
Other
Hearing Conditions
Hearing Loss
Hearing Aid(s)
Cochlear implant(s)
Life threatening health conditions(s). Please check all that apply to this student. If he/she requires a Medical Management/Emergency Care Plan, please contact your school counselor.
Asthma
Diabetes
Seizure Disorder
Allergy requiring an epi-pen
Heart Condition
Hemophilia
Mental Health (History of at risk)
Food Allergy
Other
If you child will have medication at the school for any of the above conditions, please specify.
General Health Concerns (Not life threatening). Please check all that apply to this student.
ADD
ADHD
Autism Spectrum Disorder
Mild Kidney/Bladder Conditions
Mild Asthma (No inhaler at school)
Mild Allergy (Other than seasonal allergies)
GI Condition
IBS
Mental Health Concerns
Mild Heart Condition
Migraine Headache(s)
Physical Disability
Other
Anything we need to know about the above information?
What is the primary language used in the home, regardless of the language spoken by the student?
Please check if your child qualifies for any of the following:
IEP
504
Gifted/Talented
My child has permission to attend field trips
*
Yes
No
My student may access Wewoka Schools Network and Internet under the regulations of Wewoka School's Policy.
*
Yes
No
I give consent for my child to be photographed for the yearbook, website, school social media pages, and/or newspaper. My child may be recorded in the classroom (video or audio) listed in sport's rosters, and listed in programs of any kind.
*
Yes
No
I give consent for my child to receive corporal punishment
*
Yes
No
Call First
You may share my child's personal information with any open records request
*
Yes
No
I hereby attest that the above information is correct to the best of my knowledge. All things I have given Wewoka Public Schools permission for is signed here for authenticity.
Comments
Submit
Should be Empty: