Enrollment Form - New Students Income

Household Members

Please list all students in your household that will attend Glenpool Public Schools and any adults living in this household who will be a contact for students.
Student 1 Legal Name

First Name Middle Name Last Name Suffix
Student 2 Legal Name

First Name Middle Name Last Name Suffix
Student 3 Legal Name

First Name Middle Name Last Name Suffix
Student 4 Legal Name

First Name Middle Name Last Name Suffix
Student 5 Legal Name

First Name Middle Name Last Name Suffix
Student 6 Legal Name

First Name Middle Name Last Name Suffix

Adult 1

First Name Middle Name Last Name Suffix
Adult 2

First Name Middle Name Last Name Suffix
More adults in this household to list?

Yes No
Adult 3

First Name Middle Name Last Name Suffix
Adult 4

First Name Middle Name Last Name Suffix

Relationships

Let's establish the relationship between the adults in the household and the students in this household. We will start with adut 1.
Adult 1's

First Name Middle Name Last Name Suffix
Adult 1 is the ...
Of student 1

First Name Last Name
Call Adult 1
Adult 1 is the ...
Of student 2

First Name Last Name
Call Adult 1
Adult 1 is the ...
Of student 3

First Name Last Name
Call Adult 1
Adult 1 is the ...
Of student 4

First Name Last Name
Call Adult 1
Adult 1 is the ...
Of student 5

First Name Last Name
Call Adult 1
Adult 1 is the ...
Of student 6

First Name Last Name
Call Adult 1

Relationships

Let's establish the relationship between adult 2 and the students in this household.
Adult 2's

First Name Middle Name Last Name Suffix
Adult 2 is the ...
Of student 1

First Name Last Name
Call Adult 2
Adult 2 is the ...
Of student 2

First Name Last Name
Call Adult 2
Adult 2 is the ...
Of student 3

First Name Last Name
Call Adult 2
Adult 2 is the ...
Of student 4

First Name Last Name
Call Adult 2
Adult 2 is the ...
Of student 5

First Name Last Name
Call Adult 2
Adult 2 is the ...
Of student 6

First Name Last Name
Call Adult 2
*

Done with adult relationships Establish relationship between adult 3 and students

Relationships

Let's establish the relationship between adult 3 and the students in this household.
Adult 3's

First Name Middle Name Last Name Suffix
Adult 3 is the ...
Of student 1

First Name Last Name
Call Adult 3
Adult 3 is the ...
Of student 2

First Name Last Name
Call Adult 3
Adult 3 is the ...
Of student 3

First Name Last Name
Call Adult 3
Adult 3 is the ...
Of student 4

First Name Last Name
Call Adult 3
Adult 3 is the ...
Of student 5

First Name Last Name
Call Adult 3
Adult 3 is the ...
Of student 6

First Name Last Name
Call Adult 3
Done with adult relationships Establish relationships between adult 4 and students

Relationships

Let's establish the relationship between adult 4 and the students in the household.
Adult 4's

First Name Middle Name Last Name Suffix
Adult 4 is the ...
Of student 1

First Name Last Name
Call Adult 4
Adult 4 is the ...
Of student 2

First Name Last Name
Call Adult 4
Adult 4 is the ...
Of student 3

First Name Last Name
Call Adult 4
Adult 4 is the ...
Of student 4

First Name Last Name
Call Adult 4
Adult 4 is the ...
Of student 5

First Name Last Name
Call Adult 4
Adult 4 is the ...
Of student 6

First Name Last Name
Call Adult 4

Additional information about the adults in this household.
Adult 1

First Name Last Name
Adult 1 E-mail
Household primary phone
Alternate phone for adult 1
Adult 1 alternate phone is

Cell Land Line
School Messenger Consent

Yes, I give my consent to receive automated calls from the District's messaging service on this cell number. No, I do not wish to receive automated calls from the District on my cell number.
Work phone for adult 1

Adult 2

First Name Last Name
Adult 2 E-mail
Work phone for adult 2
Alternate phone for adult 2
Adult 2 alternate phone is

Cell Land Line
School Messenger Consent

Yes, I give my consent to receive automated calls from the District's messaging service on this cell number. No, I do not wish to receive automated calls from the District on my cell number.
Done with adult information. Enter adult 3 information.

Adult 3

First Name Last Name
Adult 3 E-mail
Work phone for adult 3
Alternate phone for adult 3
Adult 3 alternate phone is

Cell Land Line
School Messenger Consent

Yes, I give my consent to receive automated calls from the District's messaging service on this cell number. No, I do not wish to receive automated calls from the District on my cell number.
Done with adult information. Enter adult 4 information.

Adult 4

First Name Last Name
Adult 4 E-mail
Work phone for adult 4
Alternate phone for adult 4
Adult 4 alternate phone is

Cell Land Line
School Messenger Consent

Yes, I give my consent to receive automated calls from the District's messaging service on this cell number. No, I do not wish to receive automated calls from the District on my cell number.

Enrollment History
Student 1's enrollment history

First Name Last Name
Grade for 1718 Term
Grade for 1819 Term *
Public school previously attended
City
State
Prior program participation for PK-KG students
Was student 1 enrolled in any of the following programs at the previous school? *

Gifted and Talented Alternative Education ELL/ESL IEP 504 Not Applicable
Is student 1 currently suspended from another school?

Yes No

Enrollment History
Student 2's enrollment history

First Name Last Name
Grade for 1718 Term
Grade for 1819 Term
Public school previously attended
City
State
Prior program participation for PK students
Was student 2 enrolled in any of the following programs at the previous school? *

Gifted and Talented Alternate Education ELL/ESL IEP 504 Not Applicable
Is student 2 currently suspended from another school?

Yes No

Enrollment History
Student 3's enrollment history

First Name Last Name
Grade for 1718 Term
Grade for 1819 Term
Public school previously attended
State of previous school
Prior program participation for PK students
Was student 3 enrolled in any of the following programs at the previous school? *

Gifted and Talented Alternate Education ELL/ESL IEP 504 Not Applicable
Is student 3 currently suspended from another school?

Yes No

Enrollment History
Student 4's enrollment history

First Name Last Name
Grade for 1718 Term
Grade for 1819 Term
Public School previously attended
State of previous school
Prior program participation for PK or KG students
Was student 4 enrolled in any of the following programs at the previous school? *

Gifted and Talented Alternate Education ELL/ESL IEP 504 Not Applicable
Is student 4 currently suspended from another school?

Yes No

Enrollment History
Student 5's enrollment history

First Name Last Name
Grade for 1718 Term
Grade for 1819 Term
Public school previously attended
State of previous school
Prior program participation for PK students
Was student 5 enrolled in any of the following programs at the previous school? *

Gifted and Talented Alternate Education ELL/ESL IEP 504 Not Applicable
Is student 5 currently suspended from another school?

Yes No

Enrollment History
Student 6's enrollment history

First Name Last Name
Grade for 1718 Term
Grade for 1819 Term
Public school previously attended
State of previous school
Prior program participation for PK students
Was student 6 enrolled in any of the following programs at the previous school? *

Gifted and Talented Alternate Education ELL/ESL IEP 504 Not Applicable
Is student 6 currently suspended from another school?

Yes No

Emergency Contact Adult 2

First Name Middle Name Last Name Suffix
Primary Phone
The number is a

Land Line Cell
Secondary Phone
The number is a

Land Line Cell
EC Adult 2 is...
Of student 1

First Name Last Name
Call EC Adult 2
EC Adult 2 is ...
Of student 2

First Name Last Name
Call EC Adult 2
EC Adult 2 is ...
Of student 3

First Name Last Name
Call EC Adult 2
EC Adult 2 is ...
Of student 4

First Name Last Name
Call EC Adult 2
EC Adult 2 is ...
Of student 5

First Name Last Name
Call EC Adult 2
EC Adult 2 is ...
Of student 6

First Name Last Name
Call EC Adult 2
Since adult 2 is a biological parent, additional information is requested.
Is this parent to receive dual notification for these students where the relationship is mother or father?

Yes No
Address
E-mail
City
State
Zip
School Messenger Consent

Yes, I give my consent to receive automated calls from the District's messaging service on this cell number. No, I do not wish to receive automated calls from the District on my cell number.

Supplemental Forms

Based on the selections made on this form, additional information is needed. The following supplemental forms or documents need to be completed for enrollment.
Home Language Survey Required
Student Residency Questionnaire required
Form 506 Required
Authorization to Transfer Records Required
Medication Form Required
Copy of Legal Documents Required
Free or Reduced Meal Application
Extended Day Application Required
You may upload and submit copies of the following document:
Birth Certificate

Upload a File

Cancel of
Immunization Record

Upload a File

Cancel of
Custody Documents

Upload a File

Cancel of
Proof of Residency

Upload a File

Cancel of

*

I acknowledge the information listed on this form is accurate to the best of my ability. I understand supplemental information may be required to complete the enrollment process. I will inform the enrollment office when information on this form needs to be updated.
Signature *
Should be Empty: