Which site are your enrolling your student in:
*
Please Select
Davis High School
Davis Middle School
Students Last Name
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Students First Name
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Students Middle Name
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MS Grade Level
Please Select
5th
6th
7th
8th
HS Grade Level
Please Select
9th
10th
11th
12th
Student SSN Number
*
Home Phone Number
*
-
Area Code
Phone Number
Cell Phone Number
*
-
Area Code
Phone Number
Would you like to recieve texts?
Yes
No
Student Birth Date
*
-
Month
-
Day
Year
Date
Student Age
*
Student Gender?
*
Male
Female
Student Birthplace
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Student Home Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Is mailing address different?
*
Please Select
Yes
No
Student Mailing Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Name of county in which you reside?
*
Students Natural Parents: Mother
*
Students Natural Parents: Father
*
Male parent/guardian with whom student resides:
*
Please Select
Natural Father
Step Father
Guardian
N/A
Male parent/guardian with whom student resides:
Name
Male parent/guardian with whom student resides:
Email: example@example.com
Male parent/guardian with whom student resides:
-
Area Code
Phone Number
Male parent/guardian with whom student resides:
Place of work
Female parent/guardian with whom student resides:
*
Please Select
Natural Mother
Step Mother
Guardian
N/A
Female parent/guardian with whom student resides:
Name
Female parent/guardian with whom student resides:
Email: example@example.com
Female parent/guardian with whom student resides:
-
Area Code
Phone Number
Female parent/guardian with whom student resides:
-
Area Code
Phone Number
Female parent/guardian with whom student resides:
Place of work
Emergency Contacts
*
Name
Relationship
Work Phone
Cell Phone
Contact 1
Contact 2
Does your student ride a bus?
*
Please Select
Yes
No
Bus Number
Last School attended?
*
Please Select
Davis
Other
Last Grade and Date enrolled?
Schools mailing adress
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Davis Public Schools Enrollment
Please specify the student's origin:
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American Indian or Alaskan Native
Oriental
Hispanic
African American
Asian or Pacific Islander
Caucasian
Does your child have a CDIB card?
*
Yes
No
Is your home on Federal property?
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Yes
No
Are any languages, other than English, spoken in the home?
*
Yes
No
If yes please mark:
Spanish
Sign
Native American
Other
Which Tribe?
Please specify:
Physician/Clinic Name
*
City
*
Phone Number
*
-
Area Code
Phone Number
Does your child have any special needs, health problems, or known allergies?
If yes, please specify
Does your child have an IEP?
If yes, please specify
Please INITIAL: Permission is given for my child to attend any school related field trip
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Please INITIAL: Permission is given to Davis Public Schools to use photographs of my child for publicity purposes in newspapers, television, yearbook and the Davis Public Schools website.
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Please INITIAL: I am aware that my child will be receiving the rules and regulations approved by the Davis Public School Board of Education, in the handbook and will abide by them as stated.
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Signature
*
Date
*
-
Month
-
Day
Year
Date
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DAVIS SCHOOL DISTRICTMEDICATION FORM
Because of the legal implications involving teachers and others who administermedication to children, it is required that this form be completed by the parent and/orphysician regarding ANY MEDICATION that needs to be administered during schoolhours. It is understood this creates no responsibility or obligation on the part of theschool faculty and staff but is done only as a service to the parent or child.I have read and understand the above paragraph and hereby authorize amember of your Davis Public Schools staff to give the medication listed below to thestudent named on this form. This will be done at my request and the staff member willnot be held accountable for any effects nor the outcome of administration of themedication, nor shall the staff be held liable in any manner whatsoever for any act ofnegligence in giving such medication or for any failure to give such medication.
Medication
Dosage
Physician Name:
Physician Phone Number
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Area Code
Phone Number
Signature
*
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Family Educational Rights and Privacy Act (FERPA)
I give permission for my students' pictures tp be published in newspapers, newsletters, websites, etc.
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Yes
No
Signature
*
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Verification of Residency in the Davis Public School District
It shall be unlawful for any person to willfully make a false or misleading statement,either verbal or written, to any officer or employee of any school in the Davis schooldistrict for the purpose of obtaining enrollment in the Davis school district and/or forthe purpose of enrolling in any particular school within the Davis school district. Anywillful misstatement on this form shall be a misdemeanor punishable byimprisonment not to exceed one {1) year or a fine not to exceed five hundred dollars{$500) or both such fine and imprisonment.
Name of Person completing enrollment
*
First Name
Last Name
Relationship to student
*
Am seeking to enroll him/her in DavisPublic Schools and I certify under penalties of perjury that I have read and understand the above statement and I further certify, under penalty of perjury, that the above-named school-age child, or children, actually live at the address input in this form.
Signature
*
Where are you and your family currently living?
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Rent/Own my own home or apartment
Temporarily with another family member or friend until we can locate affordable housing
In an emergency or transitional shelter
In a vehicle, park, campground, or on the streets
In a house, building, or trailer WITHOUT running water or electricity In a hotel or motel
With an adult that is not a parent or legal guardian
Alone or in different locations, without an adult serving as a caregiver
Wherever I can find a place to stay at night
Other
Please list all children currently living with you who attend Davis Public Schools
Name
Male or Female
DOB
Grade
School
Student 1
Student 2
Student 3
Student 4
Student 5
Student 6
What is the dominate language most often spoken by the student?
What is the language routinely spoken in the home, regardless of the language spoken by the student?
What language was first learned by the student?
Does the parent/guardian need interpretation services?
Yes
No
If so what language?
Does the parent/guardian need translated materials?
Yes
No
If so what language?
What date was the student first enrolled in the United States?
-
Month
-
Day
Year
Date
Please sign
*
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Oklahoma Title I, Part C Education ProgramIdentification & Recruitment Family Survey
Have you or your family moved from one residency to another residency in another city or town to do seasonal or temporary work related to agriculture in the last 3 years?
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Yes
No
Have your child(ren) moved from one school district to another school districtso you or your spouse could do seasonal or temporary work related toagriculture in the last 3 years?
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Yes
No
Was your move due to economic necessity or financial need? For example,moving for work or because work has ended.
*
Yes
No
Has anyone in your family worked in anything related to the jobs listed below ?Self-employment and working or owning your own land or business does not apply.
Livestock
Eggs
Chickens
Crops
Harvest
Cotton
Hay
Nursery
Vegetables
Processing
Trees
Soil Preparation
Parents Names
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Best time to call?
Please list all children (including yourself if under 22) in the household less than 22 years old who did not graduate from High School or have not obtained a GED or equivalent:
List Name - DOB - Grade - School
Davis Public Schools Policy Agreements Page
The following will be student policy agreements.
Social Media Policy
Device Use Agreement
Signature Page
Social Media Policy
Social Media Policy
Parent Signature
*
Student Signature
*
Date
*
-
Month
-
Day
Year
Date
Email
example@example.com
Preview PDF
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