McMinn County Schools 2020-2021 Kindergarten Student Registration Form- E.K. Baker

Student Information

If you are filling this out you are Zoned for E.K. Baker Elementary School

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* 1. Student's First Name (as it appears on the Birth Certificate)

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* 2. Student's Middle Name (as it appears on the Birth Certificate)

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* 3. Student's Last Name (as it appears on the Birth Certificate)

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* 4. Student's Gender

Male

Female

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* 5. Student's Preferred Name

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* 6. Social Security (requested, but not required)

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* 7. What language is spoken most often when at home?

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* 8. Place of Birth

City

County

State

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* 9. Student's Birth date

MM/DD/YYYY

Date

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* 10. Student's Race
(checked all that apply)

White

Black/African-American

Asian

Pacific Islander

American Indian

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* 11. Student's Ethnicity
(check one)

Not Hispanic

Hispanic

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* 12. Birth Certificate #

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* 13. Parent or Guardian Name

Last

First

Middle

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* 14. Parent or Guardian Name

Last

First

Middle

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* 15. Brother and Sisters in school #1

Name

Age

Grade

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* 16. Brother and Sisters in school #2

Name

Age

Grade

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* 17. Brother and Sisters in school #3

Name

Age

Grade

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* 18. Other Children at Home #1

Name

Age

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* 19. Other Children at Home #2

Name

Age

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* 20. Father's or Guardian Employer

Name

Phone

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* 21. Mother's or Guardian Employer

Name

Phone

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* 22. Home Phone

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* 23. Cell Phone:

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* 24. Address

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* 25. City

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* 26. ZipCode

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* 27. Directions to your home:

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* 28. Who will be you child’s Bus Driver?

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* 29. Bus #

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* 30. List individuals who MAY pick up student:

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* 31. Was your child enrolled in a pre-school/Pre-K program?

Yes

If Yes, What Program

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* 32. Did your child receive monthly books from Imagination/Dollywood Library?

Yes

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* 33. Are you willing to volunteer at the school if called upon?

Yes

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* 34. If school should be unexpectedly dismissed early, whom should we contact? #1

Name

Phone

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* 35. If school should be unexpectedly dismissed early, whom should we contact? #2

Name

Phone

McMinn County Schools 2020-2021 Kindergarten Student Registration Form- E.K. Baker

Student Information

Question Title

* 1. Student's First Name (as it appears on the Birth Certificate)

Question Title

* 2. Student's Middle Name (as it appears on the Birth Certificate)

Question Title

* 3. Student's Last Name (as it appears on the Birth Certificate)

Question Title

* 4. Student's Gender

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* 5. Student's Preferred Name

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* 6. Social Security (requested, but not required)

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* 7. What language is spoken most often when at home?

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* 8. Place of Birth

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* 9. Student's Birth date

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* 10. Student's Race (checked all that apply)

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* 11. Student's Ethnicity(check one)

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* 12. Birth Certificate #

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* 13. Parent or Guardian Name

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* 14. Parent or Guardian Name

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* 15. Brother and Sisters in school #1

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* 16. Brother and Sisters in school #2

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* 17. Brother and Sisters in school #3

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* 18. Other Children at Home #1

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* 19. Other Children at Home #2

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* 20. Father's or Guardian Employer

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* 21. Mother's or Guardian Employer

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* 22. Home Phone

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* 23. Cell Phone:

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* 24. Address

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* 25. City

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* 26. ZipCode

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* 27. Directions to your home:

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* 28. Who will be you child’s Bus Driver?

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* 29. Bus #

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* 30. List individuals who MAY pick up student:

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* 31. Was your child enrolled in a pre-school/Pre-K program?

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* 32. Did your child receive monthly books from Imagination/Dollywood Library?

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* 33. Are you willing to volunteer at the school if called upon?

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* 34. If school should be unexpectedly dismissed early, whom should we contact? #1

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* 35. If school should be unexpectedly dismissed early, whom should we contact? #2

* 10. Student's Race
(checked all that apply)

* 11. Student's Ethnicity
(check one)