Reeths-Puffer Enrollment Form

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NOTE: Information submitted on this form is confidential and used for educational purposes only. Your submission requires an overnight update to process. Please complete and submit this form at least one business day before you plan to visit the building office to complete enrollment.

Email *

School Year *

Please select the school year in which your student will begin attending.

2025-2026

Student Information

Student's legal name is required as listed on the Birth Certificate.

Student Name - First *

Student Name - Middle *

Student Name - Last *

Student Name - Suffix

Jr.

Sr.

III

Select one, if applicable

Clear selection

Birthdate *

YYYY

Gender *

Please select F for Female or M for Male

Is your student Hispanic or Latino? (A person of Cuban, Mexican, Puerto Rican, South or Central America, or other Spanish culture or origin, regardless of race.) *

Yes

Race

(The above part of the question is about ethnicity, not race. No matter which box you selected above, please continue to answer the following by marking one or more boxes to indicate what you consider your student’s race to be.)

American Indian or Alaska Native (A person having origins in any of the original people of North and South America, including Central America.)

African American (A person having origins in any of the black racial groups of Africa.)

Asian American (A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand and Vietnam.)

Hispanic or Latino (A person of Cuban, Mexican, Puerto Rican, South or Central America, or other Spanish culture or origin, regardless of race.)

Native Hawaiian/Pacific Islander (A person having origins in any of the original people of Hawaii, Guam, Samoa or other Pacific Islands.)

White (A person having origins in any of the original peoples of Europe, the Middle East or North Africa.)

Grade Entering *

For Kindergarten, please select 0.

Reeths-Puffer Building of Residence *

Select the building where you reside.

Reeths-Puffer Elementary

Central Elementary

Twin Lake Elementary

Home Address - Street *

Home Address - City *

Home Address - State *

Other:

Home Address - Zip Code *

Primary Telephone Number *

(Please Use Format: ###-###-####) This can be a number to receive text alerts.

Name(s) and birth date(s) of siblings, preschool or school aged children living with you:

Other people living in the home

Any health conditions or allergies the school should know about? Has your child failed a hearing screening?

Are there any special circumstances you would like the office to know about your child?

Does your child have a 504 plan? (A 504 plan is similar to an IEP for a wider range of identified disabilities) *

Yes

Does your child have an IEP for Special Education Services? *

Yes

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