K-3 Registration (Records Request Complete)

Encompass Community School Registration Packet
Only a custodial parent or legal guardian may register a student.

A legal guardian must show proof of guardianship by presenting a Record of Birth, custody papers, a court order or DCS Educational Passport.*

*Incomplete packets will not be accepted or held by Encompass Community School*
STUDNET NAME

First NameLast Name

With whom does the student reside?

Parent(s)Legal Guardian(s)Caregiver(s) who are not legal guardian(s) (ex. relatives, friends, friends of parents)Other
Statement of Residence: Where does the student stay at night?
If other, please specify:
Is this child awaiting foster care placement? If so, explain below.

Emergency Contacts to call, in order listed below, if school personnel cannot reach parent or guardian:
Contact Name #1:

Last NameFirst Name
Contact #1 Birth Date

MonthDayYear
Date
Relationship to Student
Phone Number
Please enter a valid phone number.
Gender
Contact Name #2:

Last NameFirst Name
Contact #2 Date of Birth

MonthDayYear
Date
Relationship to Student:
Phone Number
Please enter a valid phone number.
Gender

Legal Notice
Are there any court orders or Legal issues involving this student?
(If you answered yes regarding Legal Notice, you must provide a current Magistrate/Judge signed court order document.)

Cancelof

Student Health Information
Does your child have any health conditions or medical needs?

YesNo
Please upload any documentation related to the student's health conditions

Cancelof
I certify that I am the parent or guardian of the child named above and I have provided Encompass Community School with accurate information as required by State Law and that the above address is the primary residence where my child and I live. I will notify the school of any change in residency status within 10 days of that change.

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Encompass Community School Registration Packet