Student Data Form

Student Data Form

Fill out the form carefully for registration/data verification.
What school will your child attend in 2022-23?*
What grade will your student be in in 2022-23?*
What school did your student attend in 2021-22?*
Student's First Name*
Student's Middle Name*
Student's Last Name*
Birth Date*

MonthDayYear
Student Gender*

MaleFemale
STUDENT'S Physical Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Is the Mailing Address the same as the Physical Address? *
STUDENT'S Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Student's COUNTRY of Birth*
Student's STATE of Birth*
Student's CITY of Birth*
Mother's Maiden Name*
What is your student's home language?*
Will you need an interpreter/translator at parent meetings?*

YesNo
Does this student have immigrant status?*

YesNo
Is this student in foster care at this time?*

YesNo
Please check any special programs your child in which your child is served.

Exceptional EducationSpeech/Language Services504 Plan
Parent/Guardian 1 Name*

First NameLast Name
Relationship to Student*
Parent/Guardian 1 Preferred Phone Number*
Parent/Guardian 1 Other Phone Number*
Is Parent/Guardian 1's Address the same as the Student's Address?*
Parent/Guardian 1 Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian 1 Email Address*
example@example.com
Does Parent/Guardian 1 have a Skyward Family Access account? (This is where you can log in and view your student's grades, attendance, and discipline. Announcements and information are also shared here.)*
Parent/Guardian 2 Name*

First NameLast Name
Relationship to Student
Parent/Guardian 2 Preferred Phone Number
Please enter a valid phone number.
Parent/Guardian 2 Other Phone Number
Please enter a valid phone number.
Is Parent/Guardian 2's Address the same as the Student's Address?*
Parent/Guardian 2 Address (If Same as Student, Type Same in Street Address, City/State, and Zip Code)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian 2 Email Address
example@example.com
Does Parent/Guardian 2 have a Skyward Family Access account? (This is where you can log in and view your student's grades, attendance, and discipline. Announcements and information are also shared here.)
Please list below the name of any person who is allowed to pick up your student or who can serve as an emergency contact for your student. Please list the name and complete phone number of each person.*
What type of technology do you use at home?*
How do you access the internet at home? *
Is there any other information you would like to provide about your student? (Examples include, but are not limited to: allergies, vision, etc.)
Should be Empty: