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Student Enrollment Form – Middleton High School
Additional student information will need to be collected/filled out at individual schools for each child entering Middleton School District.
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* Indicates required question
Demographic Information
Student’s Legal Last Name
*
Your answer
Student’s Legal First Name
*
Your answer
Student’s Legal Middle Name
*
Your answer
Preferred Name
Your answer
Grade
*
Choose
9
10
11
12
Gender
*
Male
Female
Birth Date
*
MM
/
DD
/
YYYY
Place of Birth (City)
*
Your answer
Place of Birth (State)
*
Your answer
Place of Birth (Country)
*
Your answer
Ethnicity
*
Hispanic or Latino
Not Hispanic
Race
*
White
Asian
American Indian
Pacific Islander
Black/African American
Required
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This form was created inside of Middleton School District #134.
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