New Student Enrollment Application New Student Enrollment Application 2021-2022 Step 1 of 250%Today's Date* MM DD YYYYParent/Guardian 1 Name* First Last Parent/Guardian 1 Relationship to Student*MotherFatherLegal GuardianOtherParent/Guardian 1 Cell Phone*Parent/Guardian 1 Email* Enter Email Confirm Email Parent/Guardian 2 Name* First Last Parent/Guardian 2 Relationship to Student*MotherFatherLegal GuardianOtherParent/Guardian 2 Cell Phone*Parent/Guardian 2 Email* Enter Email Confirm Email Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Student 1 InformationStudent 1 Name* First Last Student 1 Gender*MaleFemaleStudent 1 Birthday* MM DD YYYYSchool Currently Attending*Grade entering Fall 2021 - Student 1*Kindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade7th Grade8th Grade9th Grade10th Grade11th GradeIs student a sibling of a returning student?*NoYesName of Returning Student*My student has an IEP/ALP/ELP/504.*Yes. I will provide LTA with a copy for review before enrollment can occur.No, my student does not have an IEP/ALP/ELP/504. I understand failure to disclose accurate information regarding my child’s IEP/ALP/ELP/504, could result in enrollment being denied.Please read and check all of the following statements.* Select All My child meets the age requirement. My child has not been expelled from any school district. My child has not engaged in behavior in another school that is detrimental to the welfare or safety of other students or school personnel. All the information contained in all the application or enrollment documents is accurate to the best of my knowledge.Do you have another student to enroll?*NoYesStudent 2 InformationStudent 2 Name* First Last Student 2 Gender*MaleFemaleStudent 2 Birthday* MM DD YYYYSchool Currently Attending*Grade entering Fall 2021 - Student 2*Kindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade7th Grade8th Grade9th Grade10th Grade11th GradeIs student a sibling of a returning student?*NoYesName of Returning Student*My student has an IEP/ALP/ELP/504.*Yes. I will provide LTA with a copy for review before enrollment can occur.No, my student does not have an IEP/ALP/ELP/504. I understand failure to disclose accurate information regarding my child’s IEP/ALP/ELP/504, could result in enrollment being denied.Please read and check all of the following statements.* Select All My child meets the age requirement. My child has not been expelled from any school district. My child has not engaged in behavior in another school that is detrimental to the welfare or safety of other students or school personnel. All the information contained in all the application or enrollment documents is accurate to the best of my knowledge.Do you have another student to enroll?*NoYesStudent 3 InformationStudent 3 Name* First Last Student 3 Gender*MaleFemaleStudent 3 Birthday* MM DD YYYYSchool Currently Attending*Grade entering Fall 2021 - Student 3*Kindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade7th Grade8th Grade9th Grade10th Grade11th GradeIs student a sibling of a returning student?*NoYesName of Returning Student*My student has an IEP/ALP/ELP/504.*Yes. I will provide LTA with a copy for review before enrollment can occur.No, my student does not have an IEP/ALP/ELP/504. I understand failure to disclose accurate information regarding my child’s IEP/ALP/ELP/504, could result in enrollment being denied.Please read and check all of the following statements.* Select All My child meets the age requirement. My child has not been expelled from any school district. My child has not engaged in behavior in another school that is detrimental to the welfare or safety of other students or school personnel. All the information contained in all the application or enrollment documents is accurate to the best of my knowledge.Do you have another student to enroll?*NoYesStudent 4 InformationStudent 4 Name* First Last Student 4 Gender*MaleFemaleStudent 4 Birthday* MM DD YYYYSchool Currently Attending*Grade entering Fall 2021 - Student 4*Kindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade7th Grade8th Grade9th Grade10th Grade11th GradeIs student a sibling of a returning student?*NoYesName of Returning Student*My student has an IEP/ALP/ELP/504.*Yes. I will provide LTA with a copy for review before enrollment can occur.No, my student does not have an IEP/ALP/ELP/504. I understand failure to disclose accurate information regarding my child’s IEP/ALP/ELP/504, could result in enrollment being denied.Please read and check all of the following statements.* Select All My child meets the age requirement. My child has not been expelled from any school district. My child has not engaged in behavior in another school that is detrimental to the welfare or safety of other students or school personnel. All the information contained in all the application or enrollment documents is accurate to the best of my knowledge.Do you have another student to enroll?*NoYesStudent 5 InformationStudent 5 Name* First Last Student 5 Gender*MaleFemaleStudent 5 Birthday* MM DD YYYYSchool Currently Attending*Grade entering Fall 2021 - Student 5*Kindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade7th Grade8th Grade9th Grade10th Grade11th GradeIs student a sibling of a returning student?*NoYesName of Returning Student*My student has an IEP/ALP/ELP/504.*Yes. I will provide LTA with a copy for review before enrollment can occur.No, my student does not have an IEP/ALP/ELP/504. I understand failure to disclose accurate information regarding my child’s IEP/ALP/ELP/504, could result in enrollment being denied.Please read and check all of the following statements.* Select All My child meets the age requirement. My child has not been expelled from any school district. My child has not engaged in behavior in another school that is detrimental to the welfare or safety of other students or school personnel. All the information contained in all the application or enrollment documents is accurate to the best of my knowledge.Do you have another student to enroll?*NoYesStudent 6 InformationStudent 6 Name* First Last Student 6 Gender*MaleFemaleStudent 6 Birthday* MM DD YYYYSchool Currently Attending*Grade entering Fall 2021 - Student 6*Kindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade7th Grade8th Grade9th Grade10th Grade11th GradeIs student a sibling of a returning student?*NoYesName of Returning Student*My student has an IEP/ALP/ELP/504.*Yes. I will provide LTA with a copy for review before enrollment can occur.No, my student does not have an IEP/ALP/ELP/504. I understand failure to disclose accurate information regarding my child’s IEP/ALP/ELP/504, could result in enrollment being denied.Please read and check all of the following statements.* Select All My child meets the age requirement. My child has not been expelled from any school district. My child has not engaged in behavior in another school that is detrimental to the welfare or safety of other students or school personnel. All the information contained in all the application or enrollment documents is accurate to the best of my knowledge.
