Enrollment Form for 2023-2024 School Year

This form is required for the 2023-2024 enrollment.

Additional Enrollment Information

Sleepy Eye Public School

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* 1. Student Information #1:

First Name:

Middle Name:

Last Name:

Grade:

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* 2. Student Information #2

First Name:

Middle Name:

Last Name:

Grade:

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* 3. Student Information #3:

First Name:

Middle Name:

Last Name:

Grade:

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* 4. Student Information #4:

First Name:

Middle Name:

Last Name:

Grade:

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* 5. Parent/Guardian Information:

Mother/Guardian:

Father/Guardian:

Student Information:

Court Ordered Protection Notice: This area should not be completed if there is no legal documentation provided to the school. If there is a person(s) that you have Court Ordered Legal documentation to stay away from your child, please indicate below.

Legal documentation MUST be attached to this form.

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* 6. Court Ordered Information:

Student Name(s):

Name of Person:

Address:

Relationship to Student:

Date Order Expires:

For school information purposes only. We do not set up or arrange busing services. The Sleepy Eye Bus Co. is an independent bus company and provides services for Sleepy Eye Public Schools. To arrange busing, please contact the bus company at 507-794-7941.

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* 7. Does the student(s) ride the bus?

Yes

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* 8. Does the student(s) walk home?

Yes

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* 9. Does the student(s) drive to school?

Yes

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* 10. Will the student(s) be picked up at the school?

Yes

If yes, please indicate who will be picking up the student(s).

District Questions
Check the answer that applies:

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* 11. Does the student currently live in the Sleepy Eye School District?

Yes

If no, which school district?

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* 12. Who does the student live with?

Both Parents

Father Only

Mother Only

Legal Guardian

Other: (If other, please indicate name and relationship)

Name of Legal Guardian:

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* 13. Are there any special academic or health circumstances and or educational needs the school needs to be aware of? (Health concerns, disabilities, special educational needs (IEP), family situations, etc.)

Yes

Please explain:

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* 14. Where do you live?

Single Family Home

Motel/Hotel

Shelter

Vehicle

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* 15. Migrant Status? Have you moved here in the past 2 to 3 years for seasonal or temporary agricultural work?

Yes

Please check any special programs in which the student has participated in at their previous school:

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* 16. 1# Student Name:

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* 17. Programs the above student participated in:

Speech/Language Services

Special Reading/Math Services

IEP (Individualized Educational Plan)

504 Plan (Student with disabilities, receiving accommodations)

Title One Services (Additional educational support)

Does Not Apply to this Student

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* 18. #2 Student Name:

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* 19. Programs the above student participated in:

Speech/Language Services

Special Reading/Math Services

IEP (Individualized Educational Plan)

504 Plan (Student with disabilities, receiving accommodations)

Title One Services (Additional educational support)

Does Not Apply to this Student

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* 20. #3 Student Name:

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* 21. Programs the above student participated in:

Speech/Language Services

Special Reading/Math Services

IEP (Individualized Educational Plan)

504 Plan (Student with disabilities, receiving accommodations)

Title One Services (Additional educational support)

Does Not Apply to this Student

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* 22. #4 Student Name:

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* 23. Programs the above student participated in:

Speech/Language Services

Special Reading/Math Services

IEP (Individualized Educational Plan)

504 Plan (Student with disabilities, receiving accommodations)

Title One Services (Additional educational support)

Does Not Apply to this Student

Severe Weather Information
Complete this area ONLY if you live in the country (Rural Area). Should the weather conditions become severe and your child/children would have to remain in town, please indicate below where you would like them to stay.

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* 24. Severe Weather Alternate Safety Home

Name

Company

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Relationship to the Student

Email Address

Phone Number

For each item listed, the school reserves the right to enforce these areas. We are notifying parents/guardians of each of these content areas at time of enrollment.

Acceptable use of Network:
By signing this enrollment form I give my permission for my child/children to access all components of the district network and release the district from any and all claims and damages of any nature arising from the use of this network and understand that my student must follow the rules and policies of internet use set forth by the school district.

Code of Conduct:
By signing this enrollment form I acknowledge that I received (or will soon receive) a copy and will read the Sleepy Eye Public School Handbook (contact the office if you need a copy).

Field Trip Permission:
By signing this enrollment form I give my permission for my child to accompany his/her class on any tours, trips, picnics, or excursions in or outside of the Sleepy Eye area, that are scheduled during the school day or an extended school day, for the current school year.

Basic Information Sharing:
By signing this enrollment form I give my permission to the district to share my basic information (Name, Email address) with district vendors when it may be beneficial for the parent/guardian. Example: Infinite Campus, Lifetouch, etc. Parents who wish to opt out of this sharing can alert the district office.

Photographs/Social Media, etc:
"Sleepy Eye Public School reserves the right to photograph, videotape, interview, etc. and/or display photos/school projects, etc of all Kindergarten through 6th grade elementary students either through building/classroom bulletin boards, hallway displays, television monitors within the school building, and and all forms of school websites (including Facebook, Instagram, Twitter, and You Tube creations, and/or submission of Student of the Month, Patroller of the Month photos, classroom group or individual photos, holiday projects, stores, etc. to the newspapers or media (to include Sleepy Eye Herald Dispatch, The Journal, Sleepy Eye Online, Sleepy Eye Online Facebook and Twitter pages, Sleepy Eye Herald Facebook/Twitter pages and any/all other avenues of media that these news entities may use) to promote education and school related activities." (Take Note: If you have concerns about this procedure, you must talk to the elementary principal, Mr. John Cselovszki, to have your child/children excluded).

Sleepy Eye Public shall not be held responsible or liable for the videotaping, picture taking, interviewing, etc by any outside news media groups that may come to visit Sleepy Eye Public School (on or off school property) during, before or after the regular school day during the active school year.

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* 25. I verify that the information provided on this form is correct and current. I will inform the school of any changes in this information. I authorize any school personnel to take reasonable emergency measures on behalf of my child/children and agree to hold them harmless for any treatment provided.

Your electronic signature:

Date: