Mountain View-Birch Tree School District Summer School Enrollment Form

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The Mountain View-Birch Tree RIII School will hold summer school from June 1 to June 30. Transportation and meals will be provided. Please complete and submit a form for each of your children.

Student's Legal Name (First, Middle Initial, Last) *

What grade is your child in THIS year (2022-2023)? *

PK or Head Start (going into Kindergarten next year)

Kindergarten

My child currently attends *

Birch Tree Elementary

Mountain View Elementary

Head Start

Liberty Middle School

Other:

Gender *

Female

Male

Race *

Asian

White

Native Hawaiian/Other

Pacific Islander

Black/African American

American Indian/Alaska Native

Multi-Racial

Ethnicity *

Hispanic or Latino

Not Hispanic or Latino

Transportation to and from summer school *

Parent Pick-up

Walker

Bus

Address (Physical) *

County *

Work Phone Number *

Home Phone Number *

Cell Phone Number *

Emergency Contact Name *

Emergency Contact Phone Number *

Second Emergency Contact Name *

Second Emergency Contact Phone Number *

My child MAY NOT be picked up by: *

Name of Previous School (If not MVBT School District) *

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