PARENT/GUARDIAN AND HOUSEHOLD INFORMATION.
Only the student's parent or legal guardian may complete this section.
Parent Name
*
First Name
Last Name
Does your child qualify for free or reduced lunch?
*
Yes
No
Does the parent have a college degree?
*
Yes
No
Parent Ethnicity
Black or African American
Latino or Hispanic
Asian
Native American
White
Mixed
Other
Family Income Level
$80,000 and above
$60,000 to $79,999
$40,000 to $59,999
$25,000 to $39,999
$24,999 and below
What is the best way to contact you?
Call
Text
Email
Mobile Number
*
-
Area Code
Phone Number
Work Number (optional)
-
Area Code
Phone Number
Phone Number (optional)
-
Area Code
Phone Number
Parent E-mail
*
Address
*
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
PARENT/GUARDIAN
*
Only legal guardians can complete the registration on behalf of the students
Student Registration Form
Fill out the form carefully for Registration
How many students are enrolled under Oakland Unified School District?
*
1
2
3
4
5
TOTAL (OUSD & NON OUSD)
If not in OUSD, what school district is your child currently enrolled in?
1. First Student Name
*
Birth Date For First Student
*
-
Month
-
Day
Year
Gender Of First Student
*
Male
Female
N/A
Grade Level For First Student
*
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
School Name For First Student
*
Achieve Academy
Education for Change (EFC)
Acorn Woodland
Allendale
American Indian Model School (AIMS CS)
Ascend
Aspire GSP
Aspire Triumph Technology School
Bella Vista
Bret Harte Middle School
Bridges Academy
Brookfield
Burbank in Preschool
Burkhalter
Carl Munk
Castlemont High School
Chabot
Claremont Middle School
Cleveland Elementary School
Coliseum College Prep
Community Day School
Crocker Highlands
Dewey Academy
East Oakland Pride
Edna Brewer Middle School
Elmhurst United
Emerson
Encompass Academy
Envision Arts and Technology Academy
Esperanza
Franklin
Fred T. Korematsu Discovery Academy
Fremont Elementary School
Fremont High School
Frick
Fruitvale
Garfield
Glenview
Global Family
Grass Valley
Greenleaf
Hillcrest
Hoover
Horace Mann
International Community School
Joaquin Miller Elementary School
KIPP Bridge Academy
La Escuelita
Laurel
Life Academy
Lincoln Elementary School
Lockwood Steam Academy (CUES)
Lodestar: A Lighthouse Community Public Schools (CS)
Madison Park Academy
Manzanita Community Seed
Markham
Martin Luther King Elementary School
McClymonds High School
Melrose Leadership Academy
Metwest
Monarch Academy
Montclair
Montera Middle School
New Highland
Oakland Academy of Knowledge
Oakland High School
Oakland International
Oakland Military Institute College Prep Academy (CS)
Oakland School for the Arts
Oakland Tech Fashion Academy
Oakland Technical High School
Parker
Peralta
Peralta Elementary School
Piedmont Avenue
Prescott Elementary
Ralph J. Bunche Academy
Reach Academy
Redwood Heights
Rise
Roosevelt
Rudsdale
Rudsdale Newcomer
Sankofa United
Sequoia Elementary School
Skyline High School
Sobrante Park Elementary
Sojourner Truth
Street Academy
Think College Now
Thornhill
United for Success
Urban Promise Academy
West Oakland Middle
Westlake
Yu-Ming Charter School
NON-OUSD SCHOOL
If you selected NON-OUSD SCHOOL for the first student, please type the school name below.
2. Second Student Name
*
First Name
Middle Name
Last Name
Birth Date For Second Student
*
-
Month
-
Day
Year
Gender Of Second Student
*
Male
Female
N/A
Grade Level For Second Student
*
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
School Name For Second Student
*
Achieve Academy -Education for Change (EFC)
Acorn Woodland
Allendale
American Indian Model School (AIMS CS)
Ascend
Aspire GSP
Aspire Triumph Technology School
Bella Vista
Bret Harte Middle School
Bridges Academy
Brookfield
Burbank in Preschool
Burkhalter
Carl Munk
Castlemont High School
Chabot
Claremont Middle School
Cleveland Elementary School
Coliseum College Prep
Community Day School
Crocker Highlands
Dewey Academy
East Oakland Pride
Edna Brewer Middle School
Elmhurst United
Emerson
Encompass Academy
Envision Arts and Technology Academy
Esperanza
Franklin
Fred T. Korematsu Discovery Academy
Fremont Elementary School
Fremont High School
Frick
Fruitvale
Garfield
Glenview
Global Family
Grass Valley
Greenleaf
Hillcrest
Hoover
Horace Mann
International Community School
Joaquin Miller Elementary School
KIPP Bridge Academy
La Escuelita
Laurel
Life Academy
Lincoln Elementary School
Lockwood Steam Academy (CUES)
Lodestar: A Lighthouse Community Public Schools (CS)
Madison Park Academy
Manzanita Community Seed
Markham
Martin Luther King Elementary School
McClymonds High School
Melrose Leadership Academy
Metwest
Monarch Academy
Montclair
Montera Middle School
New Highland
Oakland Academy of Knowledge
Oakland High School
Oakland International
Oakland Military Institute College Prep Academy (CS)
Oakland School for the Arts
Oakland Tech Fashion Academy
Oakland Technical High School
Parker
Peralta
Peralta Elementary School
Piedmont Avenue
Prescott Elementary
Ralph J. Bunche Academy
Reach Academy
Redwood Heights
Rise
Roosevelt
Rudsdale
Rudsdale Newcomer
Sankofa United
Sequoia Elementary School
Skyline High School
Sobrante Park Elementary
Sojourner Truth
Street Academy
Think College Now
Thornhill
United for Success
Urban Promise Academy
West Oakland Middle
Westlake
Yu-Ming Charter School
NON-OUSD SCHOOL
If you selected NON-OUSD SCHOOL for the second student, please type the school name below.
3. Third Student Name
*
First Name
Middle Name
Last Name
Birth Date For Third Student
*
-
Month
-
Day
Year
Gender For Third Student
*
Please Select
Male
Female
N/A
Grade Level For Third Student
*
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
School Name For Third Student
*
Achieve Academy -Education for Change (EFC)
Acorn Woodland
Allendale
American Indian Model School (AIMS CS)
Ascend
Aspire GSP
Aspire Triumph Technology School
Bella Vista
Bret Harte Middle School
Bridges Academy
Brookfield
Burbank in Preschool
Burkhalter
Carl Munk
Castlemont High School
Chabot
Claremont Middle School
Cleveland Elementary School
Coliseum College Prep
Community Day School
Crocker Highlands
Dewey Academy
East Oakland Pride
Edna Brewer Middle School
Elmhurst United
Emerson
Encompass Academy
Envision Arts and Technology Academy
Esperanza
Franklin
Fred T. Korematsu Discovery Academy
Fremont Elementary School
Fremont High School
Frick
Fruitvale
Garfield
Glenview
Global Family
Grass Valley
Greenleaf
Hillcrest
Hoover
Horace Mann
International Community School
Joaquin Miller Elementary School
KIPP Bridge Academy
La Escuelita
Laurel
Life Academy
Lincoln Elementary School
Lockwood Steam Academy (CUES)
Lodestar: A Lighthouse Community Public Schools (CS)
Madison Park Academy
Manzanita Community Seed
Markham
Martin Luther King Elementary School
McClymonds High School
Melrose Leadership Academy
Metwest
Monarch Academy
Montclair
Montera Middle School
New Highland
Oakland Academy of Knowledge
Oakland High School
Oakland International
Oakland Military Institute College Prep Academy (CS)
Oakland School for the Arts
Oakland Tech Fashion Academy
Oakland Technical High School
Parker
Peralta
Peralta Elementary School
Piedmont Avenue
Prescott Elementary
Ralph J. Bunche Academy
Reach Academy
Redwood Heights
Rise
Roosevelt
Rudsdale
Rudsdale Newcomer
Sankofa United
Sequoia Elementary School
Skyline High School
Sobrante Park Elementary
Sojourner Truth
Street Academy
Think College Now
Thornhill
United for Success
Urban Promise Academy
West Oakland Middle
Westlake
Yu-Ming Charter School
NON-OUSD SCHOOL
If you selected NON-OUSD SCHOOL for third student, please type the school name below.
4. Fourth Student Name
*
First Name
Middle Name
Last Name
Birth Date For Fourth Student
*
-
Month
-
Day
Year
Gender Of Fourth Student
*
Male
Female
N/A
Grade Level For Fourth Student
*
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
School Name For Fourth Student
*
Achieve Academy -Education for Change (EFC)
Acorn Woodland
Allendale
American Indian Model School (AIMS CS)
Ascend
Aspire GSP
Aspire Triumph Technology School
Bella Vista
Bret Harte Middle School
Bridges Academy
Brookfield
Burbank in Preschool
Burkhalter
Carl Munk
Castlemont High School
Chabot
Claremont Middle School
Cleveland Elementary School
Coliseum College Prep
Community Day School
Crocker Highlands
Dewey Academy
East Oakland Pride
Edna Brewer Middle School
Elmhurst United
Emerson
Encompass Academy
Envision Arts and Technology Academy
Esperanza
Franklin
Fred T. Korematsu Discovery Academy
Fremont Elementary School
Fremont High School
Frick
Fruitvale
Garfield
Glenview
Global Family
Grass Valley
Greenleaf
Hillcrest
Hoover
Horace Mann
International Community School
Joaquin Miller Elementary School
KIPP Bridge Academy
La Escuelita
Laurel
Life Academy
Lincoln Elementary School
Lockwood Steam Academy (CUES)
Lodestar: A Lighthouse Community Public Schools (CS)
Madison Park Academy
Manzanita Community Seed
Markham
Martin Luther King Elementary School
McClymonds High School
Melrose Leadership Academy
Metwest
Monarch Academy
Montclair
Montera Middle School
New Highland
Oakland Academy of Knowledge
Oakland High School
Oakland International
Oakland Military Institute College Prep Academy (CS)
Oakland School for the Arts
Oakland Tech Fashion Academy
Oakland Technical High School
Parker
Peralta
Peralta Elementary School
Piedmont Avenue
Prescott Elementary
Ralph J. Bunche Academy
Reach Academy
Redwood Heights
Rise
Roosevelt
Rudsdale
Rudsdale Newcomer
Sankofa United
Sequoia Elementary School
Skyline High School
Sobrante Park Elementary
Sojourner Truth
Street Academy
Think College Now
Thornhill
United for Success
Urban Promise Academy
West Oakland Middle
Westlake
Yu-Ming Charter School
NON-OUSD SCHOOL
If you selected NON-OUSD SCHOOL for fourth student, please type the school name below.
5. Fifth Student Name
*
First Name
Middle Name
Last Name
Birth Date For Fifth Student
*
-
Month
-
Day
Year
Gender Of Fifth Student
*
Male
Female
N/A
Grade Level For Fifth Student
*
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
School Name For Fifth Student
*
Achieve Academy -Education for Change (EFC)
Acorn Woodland
Allendale
American Indian Model School (AIMS CS)
Ascend
Aspire GSP
Aspire Triumph Technology School
Bella Vista
Bret Harte Middle School
Bridges Academy
Brookfield
Burbank in Preschool
Burkhalter
Carl Munk
Castlemont High School
Chabot
Claremont Middle School
Cleveland Elementary School
Coliseum College Prep
Community Day School
Crocker Highlands
Dewey Academy
East Oakland Pride
Edna Brewer Middle School
Elmhurst United
Emerson
Encompass Academy
Envision Arts and Technology Academy
Esperanza
Franklin
Fred T. Korematsu Discovery Academy
Fremont Elementary School
Fremont High School
Frick
Fruitvale
Garfield
Glenview
Global Family
Grass Valley
Greenleaf
Hillcrest
Hoover
Horace Mann
International Community School
Joaquin Miller Elementary School
KIPP Bridge Academy
La Escuelita
Laurel
Life Academy
Lincoln Elementary School
Lockwood Steam Academy (CUES)
Lodestar: A Lighthouse Community Public Schools (CS)
Madison Park Academy
Manzanita Community Seed
Markham
Martin Luther King Elementary School
McClymonds High School
Melrose Leadership Academy
Metwest
Monarch Academy
Montclair
Montera Middle School
New Highland
Oakland Academy of Knowledge
Oakland High School
Oakland International
Oakland Military Institute College Prep Academy (CS)
Oakland School for the Arts
Oakland Tech Fashion Academy
Oakland Technical High School
Parker
Peralta
Peralta Elementary School
Piedmont Avenue
Prescott Elementary
Ralph J. Bunche Academy
Reach Academy
Redwood Heights
Rise
Roosevelt
Rudsdale
Rudsdale Newcomer
Sankofa United
Sequoia Elementary School
Skyline High School
Sobrante Park Elementary
Sojourner Truth
Street Academy
Think College Now
Thornhill
United for Success
Urban Promise Academy
West Oakland Middle
Westlake
Yu-Ming Charter School
NON-OUSD SCHOOL
If you selected NON-OUSD SCHOOL for fifth student, please type the school name below.
STUDENT ACADEMIC RELEASE
Only the student's legal guardian may complete this form
By initialing here, you agree and understand that registration no way guarantees your child will win the challenge prize of up to $500.
*
Initials
By initialing here, you understand that images of you or your child may be captured and you consent to ONGB/partners using this image and likeness at a later date for any purpose.
*
Initials
By initialing here, you agree and understand that by registering for this contest, you are entering your child into the Every Day Counts Attendance Challenge (EDCAC). You further understand, only students with a completed EDCAC Application and Student Release form signed by the parent or legal guardian will be entered into the attendance challenge drawing.
*
Initials
By initialing here, you are agreeing to share your child's name publicly if he or she wins.
*
Initials
By initialing here, you are agreeing for ONGB to contact you in the future about ONGB Programs.
*
Initials
By signing below, you understand that you are giving consent for the school district to release student data to the Oakland Natives Give Back Fund. This includes access to your student's local assessment results, attendance rate, number of absences, online communications, gender, race/ethnicity, special education status, home language, school of enrollment, grade level, parent address, parent email, parent phone number, free/reduced-price lunch status, student name, student address, student email, student phone, local student identification number, student course grades, current and cumulative GPA.
*
Additional Comments
If you would like this page translate to another language please follow these steps
https://support.google.com/websearch/answer/3333234
Please verify that you are human
*
Submit Application
Clear Fields
Should be Empty: