St. Marks School

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New Student Registration

NEW STUDENT ENROLLMENT FORM

2024-2025 School Year

New Families ONLY

(Pending approval for all out of district and out of boundaries families)

Please Fill Out The New Student Registration Below

Please Fill Out The New Student Enrollment Form Below

Any students who are out of district will need to be approved by the district prior to enrolling your student(s).

Child #1

Child's Legal First Name

Child's Middle Name

Child's Legal Last Name

Child's Preferred Name

Gender

Reaquired field: Female

Reaquired field: Male

Date of Birth

Grade Entering for 24-25

Hispanic/Latino?

Reaquired field: Yes

Reaquired field: No

Race (check all that apply)

Reaquired field: American Indian or Alaska Native

Reaquired field: Asian

Reaquired field: Black or African American

Reaquired field: Native Hawaiian/Pac. Islander

Reaquired field: White

Does this student have an IEP?

Yes

Child #2

Child's Legal First Name

Child's Middle Name

Child's Legal Last Name

Child's Preferred Name

Gender

Female

Male

Date of Birth

Grade Entering for 24-25

Hispanic/Latino?

Yes

Race (check all that apply)

American Indian or Alaska Native

Asian

Black or African American

Native Hawaiian/Pac. Islander

White

Does this student have an IEP?

Yes

Child #3

Child's Legal First Name

Child's Middle Name

Child's Legal Last Name

Child's Preferred Name

Gender

Female

Male

Date of Birth

Grade Entering for 24-25

Hispanic/Latino?

Yes

Race (check all that apply)

American Indian or Alaska Native

Asian

Black or African American

Native Hawaiian/Pac. Islander

White

Does this student have an IEP?

Yes

Student(s) resides with:

Both Parents

Mother

Father

Shared Custody

Guardian

Other

Mother's First and Last Name:

Mother's Email Address

Mother's Phone Number

Mother's Address:

Address

City

State / Province / Region

Zipcode Min: 1 Max: 5

Country

Mother's Place of Employment

Mother's Work Number

Father's First and Last Name:

Father's Email Address

Father's Phone Number

Father's Address: (If different from mom)

Address

City

State / Province / Region

Zipcode Min: 1 Max: 5

Country

Father's Place of Employment

Father's Work Phone Number

Emergency Contact Information

This would be different from parents. We will ALWAYS contact parents first.

Emergency Contact #1

Relationship

Grandmother

Grandfather

Sibling

Daycare

Other Relative

Phone Number

Physician Name

Physician Phone Number

Preferred Hospital

Medical Notes

Email a copy to

optional

Required Fields