2019-2020 Carlisle Kindergarten Registration
Student's Legal Name
*
First Name
Middle Name
Last Name
Student's Birth Date:
*
Month/Date/Year
Student's Age on September 15, 2019
Student must be 5 years old by September 15, 2019
Birthplace:
Upload a copy of your child's birth certificate:
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If you cannot upload a copy of your child's birth certificate, you may provide a copy to the Administration Office at 430 School Street in Carlisle.
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Student's Gender
*
Female
Male
Is the student Hispanic/Latino
*
Yes
No
Student Ethnicity Information:
*
American Indian or Alaska Native
Asian
Black/African American
Native Hawaiian/Other Pacific Islander
White
Primary Language Spoken at Home:
*
Home Address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please upload a copy of your proof of residency in the Carlisle School District.
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Acceptable proof of residency includes a mortgage statement, assessor's parcel report, lease agreement, or utility bill. All acceptable items must include your name, the address and a current date.
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Preferred Household Phone Number:
*
-
Area Code
Phone Number
Parent/Guardian #1 - Name
*
First Name
Last Name
Parent/Guardian #1 - Phone
*
-
Area Code
Phone Number
Parent/Guardian #1 - Email
*
example@example.com
Parent/Guardian #2 - Name
First Name
Last Name
Parent/Guardian #2 - Phone
-
Area Code
Phone Number
Parent/Guardian #2 - Email
example@example.com
Emergency Contact #1 - List someone other than a parent/guardian who can be contacted if parent is unavailable.
*
First Name
Last Name
Emergency Contact #1 - Phone Number
*
-
Area Code
Phone Number
Emergency Contact #1 - Relationship
*
Emergency Contact #2 - List someone other than a parent/guardian who can be contacted if parent is unavailable.
First Name
Last Name
Emergency Contact #2 - Phone Number
-
Area Code
Phone Number
Emergency Contact #2 - Relationship
Daycare Provider (if applicable):
Daycare Provide Phone (if applicable):
-
Area Code
Phone Number
Will your child use the District's transportation services?
Yes
No
Did your child attend preschool?
Yes
No
Do you currently have an other students enrolled in the Carlisle Community School District?
Yes
No
Does your student have an Individual Education Plan (IEP)?
No
Yes
Does your student have a 504 Plan?
No
Yes
Please upload your child's most recent immunization record:
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You may also provide your child's immunization form to the Administration Office at 430 School Street in Carlisle.
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Thank you for registering your child for Kindergarten!
You will receive a letter in early August with child's classroom information. If you did not upload your proof of residency or your child's birth certificate and/or immunization form, please provide a copy to the Administration Office at 430 School St. in Carlisle. If you have any questions, call 515-989-3589.
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