If Guardian or Other checked above, please specify name of the person the child is living with.
Your answer
Are there any court ordered restrictions on the release of information or the dismissal of this student to either natural parent? If yes, please provide us with a copy of the legal document. *
If you answered Yes above, you agree to provide the school with the most up to date copy of the legal document and any updates as they occur in a timely manner.
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Has your child attended Nursery School? *
Enter the Name of the School they attended for Nursery. *
Your answer
Has your child attended Kindergarten? *
Enter the Name of the School they attended for Kindergarten.
Your answer
Enter the Name and Address of the School they most recently attended. *
Your answer
Enter the From and To Dates the most recently attended on the school above. *
Your answer
Enter the Name and Address of the School they previously attended. Enter NA if not applicable. *
Your answer
Enter the From and To Dates they attended on the school above. Enter NA if not applicable. *
Your answer
Enter Sibling First and Last Name, Date of Birth, and the School currently attending. *
Your answer
Enter Sibling First and Last Name, Date of Birth, and the School currently attending.
Your answer
Enter Sibling First and Last Name, Date of Birth, and the School currently attending.
Your answer
Please check any special programs your child has received.
Enter Provider of Services Name, Address, Phone, and Contact Person
Your answer
Please use this space to provide us with comments or special notes.
Your answer
By printing my name below, I, the parent/guardian, authorize the school enroll my child in the Daniel J. Bakie Elementary School. *
Your answer
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