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Moore Public Schools 2006-2007 Enrollment Form ID

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Moore Public Schools 2006-2007 Enrollment Form ID Please bring the following items to your enrollment appointment. When Moore High has received all records MOORE"( Public Schools from the sending school, the parent will be contacted by a U:AtNiN"..;f-OP. urr counselor to set up an enrollment appointment. STUDENT ENROLLMENT CHECKLIST Required Documents (missing documents will delay the enrollment process) □ Certified Birth Certificate □ Two (2) Proofs of Residence in parent/guardian'sname (any two of the following): • Current month's utility bill: Water, gas, or electric only (within lhe last ··---·-· 30 days; entire bill or top portion showing name of service holder and service address required; water bill must be from the City of Moore or City of OKC; final notices and telephone/cable/internet bills will not be accepted). • Current mortgage contracUmortgage statement/warrantydeed • Ciirrent lease/rental contract ( each student's name must be listed on contract). If the proof of residency is not in the parent/guardian's name, an affidavitis required. □ ParenUGuardian Oklahoma Driver's License or Oklahoma State Photo ID with current address listed (Exceptions: Active Duty Military and Oklahoma Commercial Driver's Licenses). • The parent who is enrolling the student must be on the birth certificate. The guardian must show legal documents proving they have the right to enroll the student. □ Academic History • • Withdrawal form from previous school (9th -12th only). • Unofficial transcript (9th-12th only). • · IEP or 504 documentation, if applicable. □ Immunization Record Immunizations must be up to date prior to starting school. Sta te D e Ja rt ment 0f Ed ucat' 10n mmumza. r 10n R ecuirement ���-�a..t-.;:,..-·-th··r.,_:.�..,,.,,:;ffi,�-t:ft'"� itm1{1��10:,tPre.':�R?:y:_:·_·��r�s:� •:.�.,K-1�,.6;�.,,.Gr� e,·.:.•: !?Lf!m!J1�1�IGra€(e:iTL::t(X:t%f2�!fGtad�Tt > .. >:" 40TaP 5 OTaP 5 DTaP 5DTaP 1 Tdap booster 3 IPB/OPV (polio) 4 IPB/OPV (polio) 4 IPB/OPV (polio) 4 IPB/OPV {polio) 1 MMR 2MMR 2MMR 2MMR 3 Hepatitis B 3 Hepatitis B 3 Hepatitis B 3 Hepatitis B 2 Hepatitis A 2 Hepatitis A 2 Hepatitis A 2 Hepatitis A 1 Varicella 1 Varicella 1 Varicella 1 Varicella *IMPORTANT! 1. You must first download a copy of the enrollment forms. The forms will not save unless downloaded to your device first. 2. Complete the downloaded forms and save again when finished. Email the saved forms directly to: [email protected] For Office Use Only Rev Jan- 2020 SCHOOL______________________ 1500 SE 4th Street 20____ - 20_____ Enrollment Form Moore, OK 73160 Grade_______ ID # ________________________ Entry Date __________________ Student Information Grade _______Bus#___________ Affidavit ______ Transfer _______ Full name: ______________________________________________________________________ Legal Last Name First Middle Birth Date: ______-______-______City & State of Birth:_________________________________ Male_____Female_____ Is student on an IEP? Y_____N______ Is student on a 504 plan? Y_____N______ Must check at least one or more of the following Races: American Indian or Alaskan Native ___ Asian___ Black/African American____Native Hawaiian or Other Pacific Islander ___ Caucasian/White____ Is the Student Hispanic or Latino Culture or Origin? Y_____N_____ Country of Birth _______________ Date entered U.S. ____-____-________ American Indian ancestry (regardless of degree) Y___N___Tribe ____________________________ (Eligible for Title VII program) Resident Address: __________________________________________________________Hm Phone (_____) _________________ *Please include suffix (Ave, Dr, Pl, etc) and Apt # City State Zip Mailing Address____________________________________________________________________________________________ *If different from resident address City State Zip Parents(s)/ Legal Guardian(s) Living with Student (1) Parent / Guardian Name ________________________________________________ Relationship to Student _______________ Last First Middle Cell (____)__________________Work (____)__________________Email________________________________@____________ Place Employed __________________________Located on Federal Property? Y___ N____ Active Military Y____N____ (2) Parent/Guardian Name/Step Parent______________________________________ Relationship to Student________________ Last First Middle Cell(____)__________________Work(____)_________________Email__________________________________@____________ Place Employed __________________________Located on Federal Property? Y____ N____ Active Military Y____N____ Are there any other children in the household attending Moore Public Schools? Y ____ N____ (1) _______________________________ Relationship to student _________________ School _________________________ (2) _______________________________ Relationship to student _________________ School _________________________ (3) _______________________________ Relationship to student _________________ School _________________________ Check One are natural parents Married _____ Divorced _____ Never Married _____ To secure your child’s safety, are current required court documents on file at the school? Y____N____ Legal custodian(s) __________________________________________________ Please list any additional Household members that are Military or Civilian working on federally owned Property: Name:_________________ Employer location/Address: ________________________________Active Military Y____N____ Parent / Legal Guardian NOT living with student Name _________________________________________________________ Relationship to Student ____________________ Last First Middle Address __________________________________________ Home (____)_________________ Cell (____)_________________ Street City State Zip Work (____)___________________ Email ___________________________________________@________________________ Place Employed __________________________Located on Federal Property? Y____ N___ Military/Branch/Rank____________________ Non-Parent Emergency Contacts (Please list in order that they are to be contacted, persons listed below will be able to check students out) Name and relationship to student Home Cell Work (1) ______________________-____________ (____)_______________ (____) _______________ (____)_______________ (2) ______________________-____________ (____)_______________ (____)________________ (____)_______________ (3) ______________________-____________ (____)_______________ (____)________________ (____)_______________ Name of last school attended: __________________________________________ City________________________ State ________ Has student ever attended a Moore Public School ______ Yes ______ No Year Attended ___________ Please check special programs that student has received: Gifted___ Lab_____Speech___OT / PT_____ Special Ed___ OK Promise___ Title I Reading___ Title IX___ JOM___ Other_____Health Care Management Plan______ Parent / Guardian Signature X __________________________________________ Date _____-_____-_________ HOME LANGUAGE SURVEY FOR PRE-K-12 SCHOOL DISTRICTS 20____- 20____ ENCUESTA DEL IDIOMA HABLADO EN CASA–DISTRITOS ESCOLARES CON GRADOS PRE - K-12 STUDENT INFORMATION 20____- 20____ HOME LANGUAGE SURVEY FOR PRE-K-12 SCHOOL DISTRICTS 20____Name- 20____ of Student:HOME ______________________________________________________________ LANGUAGE SURVEY FOR PRE-K-12 SCHOOL DISTRICTStudentS ID #_________________ Nombre del Estudiante Last Name / Apellido(s) FirstSTUDEN Name / PrimerT INFORMA Nombre TI O MiddleN Name / Segundo Nombre Identificación del Estudiante # STUDENT INFORMATION Gender: Male _____ Female _____ Date of Birth: ___________________________STUDENT INFORMATI School:ON ______________________________________________________ Sexo:NameMasculino of Student:Femenino ______________________________________________________________Fecha de Nacimiento Escuela _ Student ID # _______________ Name of Student: _______________________________________________________________ Student ID # _______________ Name of Student: ______________________________________________________________Last Name First Name Middle Name _ Student ID # _______________ Last Name First Name Middle Name Select one or more of theLa sfollowingt Name races: SeleccioneFirs unat Name o más de las siguientesMiddle razas:Name ______Gen Africander: Male American/Blac _____ Femk (Afroamericano/Negro) ale _____ Date of Birth: ________________________________ Caucasian/White (Blanco)_ School: _________________________ Asian (Asiático)_____ Gender: Male _____ Female _____ Date of Birth: ___________________________ School: ________________________ ______Gen Nativeder: M Hawaiian/Pacificale _____ Fem aleIslander ____ _ Date of Birth: ________________________________ American Indian/Alaskan_ Native School: _________________________ Other (Otro) _____ Select one or more of the following races: Select(Nativo one de or Hawáimore ofo Islasthe following del Pacífico) races: (Indio Americano/Nativo de Alaska) S______elect o neAfrican or more American/Blac of the followingk races: ______ American Indian/Alaskan Native ______ Asian ______ African American/Black ______ American Indian/Alaskan Native ______ Asian Is the______ student NativeAfrican of Hispanic Haw American/Blacaiian/Pacific or Latinok Islandeculture ror origin?_________ Yes___ _____ Caucasian/WhiteAmerican No: _____ Indian/Alaska n Native ____________ AsiaOthenr ______ Native Hawaiian/Pacific Islander ______ Caucasian/White ______ Other ¿El estudiante______ Native es de origen Hawaiian/Pacific o cultura Hispana Islande o Latina?r ___Sí___ Caucasian/White ______ Other Is the
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