New Middle School Student Enrollment
Please fill out this form to enroll in Shoals Middle School grades 6-8. If you have any questions, please contact Darla Holt at 812-247-2060 ext. 707 or email darla.holt@shoals.k12.in.us
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Date *
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Last Name *
First Name *
Middle initial
Date of Birth *
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Address *
Phone number #1 *
Phone number #2
Grade Enrolling *
School last attended *
Gender *
Race *
Guardian Information *
Additional Contact Info: Email
Who is responsible for book fees? *
Do you want to apply for free/reduced textbook and lunch? *
Mother or Guardian Last Name *
Mother or Guardian First Name *
Mother or Guardian Address *
Mother or Guardian Phone *
Mother or Guardian Employer
Mother or Guardian Employer phone
Father or Guardian Last Name *
Father or Guardian First Name *
Father or Guardian Address *
Father or Guardian Phone *
Father or Guardian Employer
Father or Guardian Employer Phone
Physician Information (name, address, phone, hospital preference)
Allergies
Medications
Health Concerns
Emergency Contact #1  (Name, relationship, and phone)
Emergency Contact #2  (Name, relationship, and phone)
Emergency Contact #3  (Name, relationship, and phone)
Does your child have an IEP or Individual Education Plan for Special Education?
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Do you have any education concerns that our teachers should be aware of?
Sibling Information #1 only enrolled in Shoals. (Name and Grade)
Sibling Information #2 only enrolled in Shoals. (Name and Grade)
Sibling Information #3 only enrolled in Shoals. (Name and Grade)
Any other comments?
Thank you for your application and we are so excited to meet your student! Please go back and fill out the request for student records form, the directory release information form, home language survey, immunization form, medical form, parent field trip volunteer criminal history check, and out of district application form if your child does not reside in the Shoals Community School District. Parents must supply the school with a copy of the student's birth certificate, social security card, and proof of residency which can be in the form of a utility bill, doctor's statement, driver's license, etc. The proof must have the full name and address in which the child resides.
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