Arp ISD Enrollment Information Sheet
Date Initiated:
_________________________ Student ID
________________
Student’s (Legal)
Name_______________________________________________________________________________ Last Middle First
Date of
Birth____________/_____________/_______________ Grade_____________________
Student’s
Address_______________________________City____________________State_________Zip____________
Student’s Social Security
#___________-________-__________
Ethnicity______________________
Parent/Guardian____________________________________________________________________
Parent/Guardian Address if different
from student:
_______________________________________ City___________________State______________Zip_______________
Home Phone # (_______)___________-_____________
Home Phone # (________)___________-____________
Cell Phone #
(________)___________-_____________
Other Phone # (________)___________-____________
Email Address:_________________________________________________
Place of Employment:____________________________________________
Emergency Contact Information:
Name:_______________________________________ Relationship to Student_________________
Address:___________________________________________
Phone #_________________________
Dates and Grades Attended at above
school:_____________________________________
Special Services your child received at previous
school (Please check all that apply)
|
Service |
Check |
|
Gifted & Talented |
|
|
Special Education |
|
|
504 |
|
|
Dyslexia |
|
|
Speech |
|
|
Bilingual Education (ESL) |
|
If your child has any existing medical conditions
the school should be aware of, please list them.
_________________________________________________________________________________