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New Student Online Enrollment - Hamer Elementary

Please complete the form below. Required fields marked with an asterisk *

BASIC STUDENT DEMOGRAPHICS:

Informacion Basico Del Estudiante

Gender*
Geneor
Answer Required
Grade Level*
Nivel de grado
Answer Required
Ethnic Code [Codigo Etnico]*
Choose one of the following Federally Mandated Categories [Escoja una]
Answer Required

Student Address

Direccion 

State*
Estado
Answer Required

Maling Address, if different

La direccion postal (Si diferente)

SPECIAL PROGRAMS [Programas Especials]
Check all special programs or services in which the student has participated:
Answer Required

PARENT INFORMATION 

Informacion de los Padres

Custody:*
La Custodia
Answer Required
Student Lives With*
El Estudiante vive con
Answer Required
Legal Documentation on File*
Documentacion Legal en Los Archivos
Answer Required

PARENT/GUARDIAN   List the parents/guardians the student lives with first.

List los padres/guardians que el estudiante vive con primero

1.  Birth Parent/Guardian 

Primer Padre/Guardian

Lives with Student *
Viven con el estudiante
Answer Required
Speaks English? *
Habla Ingles
Answer Required

Address, if different from Student’s 

 Direccion (Si es diferente del estudiante)

State
Answer Required

2.  Birth Parent/Guardian [Primer Padre/Guardian]

Relationship to Student *
[El relacion con el estudiante]
Answer Required
Lives with Student
[Viven con el estudiante]
Answer Required
Speaks English?
[Habla Ingles]
Answer Required

Address, if different from Student’s  [Direccion (Si es diferente del estudiante)]

Parent  Address

State
Answer Required

OTHER EMERGENCY CONTACTS:   Include Daycare Information here

Otra Contactos Emergencias: incluye guidado de ninos

First Emergency Contact  [Primero Contacto de Emergencia]

Lives with Student *
[Viven con el estudiante]
Answer Required
Speaks English? *
[Habla Ingles]
Answer Required

Second Emergency Contact  [Segundo Contacto de Emergencia]

Lives with Student *
[Viven con el estudiante]
Answer Required
Speaks English? *
[Habla Ingles]
Answer Required

SIBLING INFORMATION [Informacion del Hermanos ]

Name      Relationship           Age             Gender           School Attending

Nombre        Relacion          Edad         Genero          Escuela de Asistencia

MEDICAL/HEALTH INFORMATION [informacion/medical/salud]

OTHER STATE REQUIRED STUDENT INFORMATION [orta informacion requirida por el estado]

Immigration Status
[Posicion de inmigracion]
Answer Required
Migrant Worker
[El Trabajador migratorio]
Answer Required
Moved in the Last 36 Months
[Movido en los Ultimos 36 Meses]
Answer Required

All information given on this sheet is confidential and only for school use.

Toda infromacion es confidncialpara el uso de la Escuela.

Please report changes to any of this information to the school office within 14 days.

Favor de reportar cambios a la oficina dentro de 14 dias.

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