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2020-2021 New Student Registration
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* Indicates required question
School Enrolling
*
Choose
Eli Terry Elementary School
Orchard Hill Elementary School
Philip R. Smith Elementary School
Pleasant Valley Elementary School
Timothy Edwards Middle School (Grades 6-8)
South Windsor High School (Grades 9-12)
Not sure
Student Grade Level
*
Choose
Pre-K
Kindergarten
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
Grade 7
Grade 8
Grade 9
Grade 10
Grade 11
Grade 12
Student's First Name
*
Your answer
Student's Middle Name
Your answer
Student's Last Name
*
Your answer
Student's Gender
*
Choose
Female
Male
Student's Date of Birth
*
MM
/
DD
/
YYYY
Have you moved to South Windsor in the past two years?
*
Choose
Yes
No
Primary Phone Number
*
000-000-0000
Your answer
Student address (if applicable include apt/unit)
*
i.e. 99 Main St, Apt 3
Your answer
City
*
Your answer
Zip Code
*
Your answer
Name of Parent/Guardian #1
*
Your answer
Name of Parent/Guardian #2
Your answer
Parent/Guardian E-Mail Address
*
Your answer
Are you the parent or legal guardian of this student?
*
Choose
Yes
No
Do you live with student at address listed above?
*
Choose
Yes
No
Has your child recently arrived from a high risk state or country?
*
Yes
No
Unsure
If you answered "Unsure" to the question above, please provide the location you are coming from
Your answer
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