MSAD 52 Student Enrollment Form
Sign in to Google to save your progress. Learn more
School *
Please select the school you are registering your student for.  Greene Central School is for Greene, grades Pre-K to 6.  Leeds Central School is for Leeds, grades Pre-K to 6.  Turner Primary School is for Turner, grades Pre-K to 2.  Turner Elementary School is for Turner, grades 3-6.  Tripp Middle School is for Greene, Leeds and Turner, grades 7 or 8.  Leavitt Area High School is for Greene, Leeds and Turner, grades 9-12.
Previous School *
Please list the name of the previous school attended.  Please also include a location and if you have it, a contact number.  If this is a new enrollment, for a student never being in school before, state New Enrollment
Is the student currently under an expulsion from another school? *
Are you registering for the current school year, or next year? *
Student Last Name *
Student First Name *
Student Middle Name *
Date of Birth *
MM
/
DD
/
YYYY
Age *
Daycare
If your child attends daycare, please list the daycare here.  If they attend multiple different daycares, please list them all, as well as which days they attend each daycare.
Gender *
Home Phone Number *
This is the number that will get all automated calls from the school
Alternate Home Phone Number
This number will also get automated calls from the school, if you'd like a second number listed
Grade Level *
Military Connection *
Home Language *
Home Schooled *
You should answer yes if you are keeping home based education and enrolling in the school part time
Special Education *
Please select No if there is no IEP, or select the disability if there is an IEP
Sibling's Name(s) and School(s)
Please list siblings who will also be in school in the district, as well as which building they will be attending.
Was this student previously enrolled in an MSAD 52 School? *
Please select no, or the most recent school the student attended if they have been enrolled int he district previously
Home Address
Must be a physical address
Home Street, Apt/Suite *
Home City *
Home State *
Home Zip Code *
Mailing Address
Enter your mailing address if different than your home address, or leave blank if it's the same
Mailing Street, Apt/Suite
Mailing City
Mailing State
Mailing Zip
Demographic Information
Is the student Hispanic or Latino? *
Federal Reporting Ethnicity *
These are the list the federal government requires us to use.  Please select the appropriate box or boxes.
Required
Student Lives With *
Mother's Name *
Last, First MI
Mother's Day Phone
Mother's Work Phone
Mother's Home Phone
Mother's Cell Phone
Mother's Employer
Mother Permissions
Mother's Marital Status
Clear selection
Mother's Email Address
Mother's Address
If different from the student
Father's Name *
Last, First MI
Father's Day Phone
Father's Work Phone
Father's Home Phone
Father's Cell Phone
Father's Employer
Father Permissions
Father's Marital Status
Clear selection
Father's Email Address
Father's Address
If different from the student
Other Guardian's Name
Last, First MI
Guardian Day Phone
Guardian Home Phone
Guardian Cell Phone
Father's Significant Other
Ignore this section if it isn't applicable
Father's SO Name
Father's SO Day Phone
Father's SO Home Phone
Father's SO Cell Phone
Father's SO Permissions
Mother's Significant Other
Ignore this section if it isn't applicable
Mother's SO Name
Mother's SO Day Phone
Mother's SO Home Phone
Mother's SO Cell Phone
Mother's SO Permissions
Emergency/Medical Contacts
These need to be someone other than the parents listed above, as these will be used when parents cannot be reached
Contact 1 Name *
Contact 1 Relationship *
Relationship to the student
Contact 1 Phone Number *
Contact 1 Phone Type *
Contact 2 Name
Contact 2 Relationship
Relationship to the student
Contact 2 Phone
Contact 2 Phone Type
Contact 3 Name
Contact 3 Relationship
Relationship to the student
Contact 3 Phone
Contact 3 Phone Type
Doctor's Name *
Doctor's Phone *
Dentist's Name
Dentist's Phone
Special Medical Considerations
List anything the school needs to be made aware of here with medical conditions
Allergies
Other Alerts
Any other information that it's important the school know about your student
Bus Information
Bus Number
If you know what bus your student will ride, list it here, otherwise leave this blank
Bussing Location
Clear selection
Bus not home name
List the name of the relative, or day care, or other person student will be bussed to if they are not going to their home
Bus not home address
List the address if not being bussed home
Bus other information
Please list any other important information regarding the transportation of your student that the district needs to be aware of
Residency (McKinney-Vento) Section
Your child may be eligible for additional educational services depending on your housing situation. Additional services and rights include the right to stay at the same school even if you move and access to free meals at school. Eligibility can be determined by completing this questionnaire.
1A Where do you and your family currently live?
If you select this, you are done this form, do not complete 1B or 2
Clear selection
1B Where has your family stayed at night?
Please check ALL the boxes for places you have slept over the past year.
2 If you checked a box in 1B, please provide information
Please list any other children, including children who are not yet school aged.  Give their first, middle, last name, their date of birth, their grade (if applicable) and their school name (if applicable)
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of rsu52.us. Report Abuse
Google Forms