Newell School District 9-2 Registration
Please fill out the below document to register your student for the Newell School District

***Office needs copies of: birth certificate, immunization records copy of social security card***
Also, any legal documents that deal with guardianship, adoption, custody and/or parental rights of this child should be submitted as soon as possible.

*By submitting this form, you are acknowledging that all of the below information is true and accurate. If you have questions or need help with any section please contact the school.*
Sign in to Google to save your progress. Learn more
Email *
Full name of Child (first, middle, and last) *
Child's Mailing Address *
Child's Physical Address *
Grade: *
Social Security Number
(If you do not want to type it here you may bring in a copy to the office)
Date Of Birth *
MM
/
DD
/
YYYY
Place of Birth *
Child's Ethnic Background *
What language is most frequently spoken at home? *
Male/Female:
Clear selection
Mother's Details: Mothers Name *
Mother's Details: Occupation *
Mother's Details: Employer *
Mother's Details: Work Phone *
Mother's Details: Mobile Phone *
Mother's Details: Email Address *
Mother's Details: Address (if different from child's)
Father's Details: Father's Name *
Father's Details: Occupation *
Father's Details: Employer *
Father's Details: Work Phone *
Father's Details: Mobile Phone *
Father's Details: Email Address *
Father's Details: Address (if different from child's)
Who has parental responsibility? *
Other Emergency Contacts: Name, Phone Number, and relationship to child. *
Other Emergency Contacts: Name, Phone Number, and relationship to child.
Doctor Details: Doctors Name *
Doctor Details: Doctors Address *
Doctors Details: Phone Number *
Other Children in the Household Ages 0-21:    Please list first and last name, age, M/F, and Date of Birth for each child *
Last school Attended: (Fax and phone number if known) *
Does this child receive special services (IEP, 504, OT, PT, Speech or other special services) If yes, please choose other and explain. *
Required
Does this child have any health or physical problems? If yes, please choose other and explain. *
Required
Does this child have allergies or asthma? If yes, please choose other and explain. *
Required
Does this child take any medication? If yes, please choose other and explain. *
Required
Is there anything that this child cannot eat or drink due to allergies? If yes, please choose other and explain. *
Required
Does this child have a history of illnesses, accidents, or operations? If yes, please choose other and explain. *
Required
Has this child ever been suspended more than 10 days or expelled from any previous school? If yes, please choose other and explain. *
Required
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of State of South Dakota K-12 Data Center. Report Abuse