23-24 Enrollment Form | Berkeley Unified School District

BUSD Enrollment Form

School Year 2023-24
Select Enrollment Form:*
Enrollment Dates for 2023-2024 School Year:
TK, Elementary & Middle
- Round One: January 2 – February 3, 2023
- Round Two: February 6 – May 19, 2023
- Round Three: May 22 – June 23, 2023
- Ongoing: June 26, 2023 and beyond
Enrollment Dates for 2023-2024 School Year:
High School
- Round 1: November 14 – December 16th, 2022
- Round 2: March 27 – May 19, 2023
- Round 3: May 22 – June 23, 2023
- Ongoing: June 26, 2023 and beyond
Grade in 23-24:*
Grade in 23-24:*
Elementary School
Grade in 23-24:*
Middle School
Grade in 23-24:*
High School
Grade in 23-24:*
Independent Study
Email Address*
Make sure it's correct. Your completed form will be sent to this email address.
Student's First Name*
Type name as it appears on birth certificate.
Student's Last Name*

TRANSITIONAL KINDERGARTEN
Students who will turn 5 between September 2nd & April 2nd must attend a transitional kindergarten program.

The transitional kindergarten program follows the guidelines of the California Department of Education. It is aligned with the changing entry date for kindergartners and offers placement for students who, prior to the new law, would have been eligible for regular kindergarten.

Please note: The assigned school will be for transitional kindergarten only. You will need to apply for a kindergarten assignment in January 2024.

ELEMENTARY SCHOOL

Ranked School Preferences
District-Wide Dual Immersion

This lottery runs first. This selection will be considered before the rankings in the Regular program selection.
Are you interested in enrolling your child in Sylvia Mendez Two Way Immersion (TWI)?*

Yes, I am interested in Two Way ImmersionNo
Regular Program
Which BUSD Zone are you in?*

Northwest ZoneCentral ZoneSoutheast ZoneNon Berkeley Resident
Not sure? Click here to find your BUSD Zone.
Click and drag the Northwest schools below in order of preference:*
Click and drag the Central schools below in order of preference:*
Click and drag the Southeast schools below in order of preference:*
Rank the Northwest Schools from 1-4:*
Rank the Central Schools from 1-5:*
Rank the Southeast Schools from 1-3:*
Rank your top six schools from 1-6, put 0 for the other four:*

MIDDLE SCHOOL

Ranked School Preferences
District-Wide Dual Immersion Program

Students who attend Sylvia Mendez and Thousand Oaks will have priority and will be assigned Longfellow's two way Dual Immersion. Students not attending Sylvia Mendez or Thousand Oaks will be considered after and based in space availability.
Longfellow Dual Immersion (6th graders only)
Regular Program
Click and drag the schools below in order of preference:*
Please note: Students are given priority to their attendance zone (Longfellow, King or Willard) provided space is available. Out of zone students will be considered after in zone students have been assigned. Click here to find your BUSD Zone.

HIGH SCHOOL
School Preference*

Berkeley High SchoolBerkeley Technology Academy (16+)
Berkeley Technology Academy is available to students 16 and older in grades 10-12.

Please note: A meeting with school administrators is required for enrollment into BTA. You will recieve information about this after submitting enrollment documents.

INDEPENDENT STUDY
Please note: A meeting with independent study staff is required for enrollment. You will recieve information about this after submitting enrollment documents.

Learn more about Berkeley Independent Study.

Two Way Immersion (TWI) Applicant Survey
Who are the family members who live with you and the child?*

0/250
Who is the primary caregiver of your child?*

ParentGrandparentAunt/UncleOlder SiblingLegal Guardian
What language does the primary caregiver speak most often with the child?*
What language(s) do each of the following people in your household speak to your child?
Parent 1*
Specify other language(s):*
Parent 1
Parent 2
Specify other language(s):*
Parent 2
Older sibling(s)
Specify other language(s):*
Older sibling(s)
Grandmother
Specify other language(s):*
Grandmother
Grandfather
Specify other language(s):*
Grandfather
Aunts/Uncles
Specify other language(s):*
Aunts/Uncles
Others
Specify other language(s):*
Others in the household.

STUDENT INFORMATION
Student Name: {childsFirstName} {childsLastName}
Date of Birth*

MonthDayYear
Date
Birthplace*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Age*
Gender*

MaleFemaleNon Binary

Assignment of Students

Students will be admitted to schools in accordance with six established priority categories. A computer assignment system will assign students on a random basis within a priority for each grade level within each school. Priority requirements are as follows:

1st priority: BUSD students currently attending the school (with the exception of transitional kinder) and living within attendance zone

2nd priority: BUSD students currently attending the school (with the exception of transitional kinder) and living outside the attendance zone

3rd priority: Berkeley residents who are siblings of any student currently attending the school on the basis of the first or second priority and who will continue in attendance for the 2023/24 school year

4th priority: Berkeley residents not currently attending the school and living within the attendance zone

5th priority: Berkeley residents not currently attending the school and living outside the attendance zone

6th priority: All non-Berkeley resident students requesting inter-district transfers
I verify that the information on this form is complete and true.
Signature*

Clear
Date*

MonthDayYear
Date

DECLARATION OF RESIDENCY
Do you reside in Berkeley?*

YesNo
Non-Berkeley residents will be considered after all Berkeley residents are placed and if there is space available in the requested grade. Please see more information about Inter-District Permits & Transfers.
I declare that the Berkeley residency information provided below is true and correct.
Parent/Guardian Name:*

First NameLast Name
Email Address:*
example@example.com
Cell Phone:*

Area CodePhone Number
Landline Phone:

Area CodePhone Number
Work Phone:

Area CodePhone Number
Primary Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
The following children under the age of 18 reside in the Berkeley household:
Number of children in household:*
Child 1
First Name:*
Last Name:*
Date of Birth:*

MonthDayYear
Date
Current School:*
Current Grade:*
Child 2
Child's Name:*

First NameLast Name
Date of Birth:*

MonthDayYear
Date
Current School:*
Current Grade:*
Child 3
Child's Name:*

First NameLast Name
Date of Birth:*

MonthDayYear
Date
Current School:*
Current Grade:*
Child 4
Child's Name:*

First NameLast Name
Date of Birth:*

MonthDayYear
Date
Current School:*
Current Grade:*
Child 5
Child's Name:*

First NameLast Name
Date of Birth:*

MonthDayYear
Date
Current School:*
Current Grade:*
Child 6
Child's Name:*

First NameLast Name
Date of Birth:*

MonthDayYear
Date
Current School:*
Current Grade:*
I certify that my children and I are residents of the city of Berkeley. Depending on the individual student’s circumstances at times it may be necessary to conduct residency verifications to ascertain the student’s domicile. If residency verification efforts determine that we do not reside in Berkeley, I realize that my child may be dropped from enrollment and returned to his/her district of residence within twenty (20) days.

I understand that I must notify the Admissions Office of any changes in domicile within ten (10) days. If I move within Berkeley, I must also submit the required proofs of Berkeley residency within thirty (30) days to the District’s Admissions Office. If I move out of Berkeley, at that time, I may apply for an interdistrict permit, which, if approved, may allow my child to continue in the Berkeley public schools.

This declaration is made under the penalty of perjury under the laws of the State of California and entered on the date below in Berkeley, Alameda County, California.
Signature*

Clear
Relationship to student(s):*
Date*

MonthDayYear
Should be Empty:

BUSD Enrollment Form

TRANSITIONAL KINDERGARTEN

ELEMENTARY SCHOOL

MIDDLE SCHOOL

HIGH SCHOOL

INDEPENDENT STUDY

Two Way Immersion (TWI) Applicant Survey

STUDENT INFORMATION

PARENT/GUARDIAN INFORMATION

Parent 1

Parent 2

DEMOGRAPHIC INFORMATION

EDUCATIONAL BACKGROUND

DECLARATION OF RESIDENCY

The following children under the age of 18 reside in the Berkeley household:

Child 1

Child 2

Child 3

Child 4

Child 5

Child 6