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District 66 New Student Registration 2020-2021
Please complete this form to register your student for the 2020-2021 school year. In addition to this form, you must turn in all necessary documentation and fee payments to the District Office prior to the start of school.
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* Indicates required question
Email
*
Your email
Student ID Number
*
Your answer
Student Last Name
*
Your answer
Student First Name
*
Your answer
Residency
*
I am a legal resident of Center Cass School District #66.
I acknowledge and agree
Demographic Information
Is this student Hispanic/Latino?
*
A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race.
Yes
No
Ethnicity (Federal Reporting)
*
Please choose one
Choose
11 - Hispanic/Latino
12 - American Indian/Alaska Native
13 - Asian
14 - Black or African American
15 - Native Hawaiian or Pacific Islander
16 - White
17 - Multi-Racial - Two or More Races
Race (Illinois Reporting)
*
Please choose one
Choose
I - American Indian or Alaska Native
A - Asian
B - Black or African American
P - Native Hawaiian or Other Pacific Islander
C - Caucasian
O - Other
Country of Birth
*
Your answer
City and State of Birth
*
Your answer
Language Spoken at Home
*
Your answer
Lives with
*
Choose
Mother / Guardian
Father / Guardian
Both Parents
Mother & Stepparent
Father & Stepparent
Other
Custody Rights
*
Do you have a court ordered parenting plan?
Yes (If yes, please provide a copy to the District Office.)
No
Required
Mother's or Guardian's Name
*
Last Name, First Name (Doe, Jane) *Use N, A if not applicable
Your answer
Mother's or Guardian's Employer
*
*Use N, A if not applicable
Your answer
Mother's or Guardian's Primary Phone Number
*
ex: 630-867-5309 * Use N-A if not applicable
Your answer
Mother's or Guardian's Secondary Phone Number
*
ex: 630-867-5309 *Use N-A if not applicable
Your answer
Mother's or Guardian's Cell Phone Number
*
ex: 630-867-5309 *Use N-A if not applicable
Your answer
Father's or Guardian's Name
*
Last Name, First Name (Doe, Jane) *Use N, A if not applicable
Your answer
Father's or Guardian's Employer
*
*Use N, A if not applicable
Your answer
Father's or Guardian's Primary Phone Number
*
ex: 630-867-5309 *Use N-A if not applicable
Your answer
Father's or Guardian's Secondary Phone Number
*
ex: 630-867-5309 *Use N-A if not applicable
Your answer
Father's or Guardian's Cell Phone Number
*
ex: 630-867-5309 *Use N-A if not applicable
Your answer
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