Gaming and Technology Academy Enrollment Application
Child's Legal Name
*
First Name
Last Name
Grade Entering
*
Please Select
Pre-K
K
1st
2nd
3rd
4th
5th
6th
7th
8th
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Child's Birth Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Gender
*
Male
Female
Birth Status
*
Single
Twin
Triplet+
Primary Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
By providing your phone number, you agree to receive communication via text from GATA.
County of Residence
*
Are you a military family?
*
Yes
No
Is English the primary language spoken in your home?
*
Yes
No
If no, what is the primary language spoken?
Previous School Attended
*
What do you consider your child's race? (check all that apply)
*
American Indian/Alaskan Native
Asian American
Black/African American
Hispanic/Latino
Native Hawaiian/Pacific Islander
White/Caucasian
Did your child receive special education services at a previous school?
*
Yes
No
If yes, please indicate what types received (please bring a copy of the IEP)
Special Education classes
Speech
OT/PT
Social Work
504 Plan
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Parent/Guardian Name
*
First Name
Last Name
GATA Text Message Consent
I agree to receive informational SMS/text messages from Gaming and Technology Academy of Saginaw (GATA) at the mobile number provided. Messages may include school announcements, closures or delays, emergency notifications, event reminders, transportation updates, attendance-related notices, and other school-related information. Message frequency varies. Message and data rates may apply. Reply STOP to opt out or HELP for help. Consent to receive text messages is not a condition of enrollment.
Agree
Parent/Guardian
*
Custodial
Non-Custodial
Relationship to Child
*
Date of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Employer
*
Employer Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Parent/Guardian Name
*
First Name
Last Name
Parent/Guardian
*
Custodial
Non-Custodial
Relationship to Child
*
Date of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Employer
*
Employer Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
If there is a custody order in place, please provide court documentation to the office
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Has your child ever been suspended from school?
*
Yes
No
If yes, why?
Has your child ever been expelled from school?
*
Yes
No
If yes, why?
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MCKINNEY-VENTO HOMELESS QUESTIONNAIRE
Where is the child currently living? (Please check one box. If one of the following boxes is checked, the school may be required to fill out a McKinney-Vento referral.)
*
In a shelter
With family/friends (with parent)
In a one family dwelling
In a hotel/motel
Homeless
Other
Other
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Emergency Contact Information
In the case my child becomes ill or injured at school and I cannot be reached for any reason please contact the following: (please list in order you would like contacted)
Name
*
First Name
Last Name
Relationship
*
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Phone Number 2
*
Please enter a valid phone number.
Format: (000) 000-0000.
Does your child have any allergies or medical problems that the school should be aware of?
*
Name
*
First Name
Last Name
Relationship
*
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Phone Number 2
*
Please enter a valid phone number.
Format: (000) 000-0000.
Does your child have any allergies or medical problems that the school should be aware of?
*
Submit
Should be Empty: