Registration Form Enrollment/Re-Enrollment Fee: $175.00 *Please Note: Filling out this form alone does not register your child, the school must receive payment before your child will be considered fully registered/re-registered. Please enable JavaScript in your browser to complete this form.Student InformationI am Enrolling *a new studenta current student for next yearDo you have any siblings currently enrolled? *NoYesPlease list name(s) of enrolled sibling(s)Last Name of Student *First Name of Student *Middle InitialNicknameDate of Birth *MM123456789101112/DD12345678910111213141516171819202122232425262728293031/YYYY202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Upload Birth Certificate Gender *FemaleMaleReligion *Non-CatholicCatholicParish *Upload Baptismal CertificateUpload Certificate of First ReconciliationUpload Certificate of First CommunionUpload Certificate of ConfirmationApplying for Entry into Grade *PreKKindergartenFirstSecondThirdFourthFifthSixthSeventhEighthPublic School District *Cincinnati Public School DistrictDeer Park Community City School DistrictFinneytown Local School DistrictForest Hills Local School DistrictIndian Hill Exempted Village School DistrictLockland City School DistrictLoveland City School DistrictMadeira City School DistrictMariemont City School DistrictMount Healthy City School DistrictNorth College Hill City School DistrictNorthwest Local School DistrictNorwood City School DistrictOak Hills Local School DistrictPrinceton City School DistrictReading City School DistrictSouthwest Local School DistrictSt. Bernard - Elmwood Place City School DistrictSycamore Community City School District - Sycamore High SchoolThree Rivers Local School DistrictWinton Woods City School District - Winton Woods High SchoolWyoming City School DistrictPublic School Building (Name) *Are you transferring from or currently enrolled in another school?NoYesPrevious School AttendedPrevious School Phone Previous School FaxPrevious School Address Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeUpload Previous Report Card(s)Do you want to apply for bus service? *YesNoAccess the scholarship form here: https://online.factsmgt.com/signin/3XF84Will you be applying for an Ohio EdChoice Scholarship? *NoYesAccess the scholarship form here: https://online.factsmgt.com/signin/3XF84Which Program? EdChoice Traditional - Reside in failing school districtEdChoice Expansion - Qualify for Low Income EligibilityAccess the scholarship form here: https://online.factsmgt.com/signin/3XF84 Income eligibility guidelines: http://education.ohio.gov/getattachment/Topics/Other-Resources/Scholarships/EdChoice-Scholarship-Program/FederalPovertyGuidelines.pdfFamily InformationStudent Resides With *Both ParentsMotherFatherShared Custody (1/2 & 1/2)Legal GuardianUpload Court/Custody DocumentsPrimary Guardian Name *FirstLastPrimary Guardian SSN *If you do not have a SSN, please enter all 0's. You will be contacted by our Business Office to gather supporting documents. Not providing your SSN will delay your child's acceptance or push them to a waiting list. Primary Guardian Relationship *MotherFatherLegal GuardianPrimary Phone *Primary Email *Primary Mailing Address *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePrimary Occupation & Place of Employment *Primary Work PhoneSecondary Guardian Name FirstLastSecondary Guardian SSN Secondary Guardian RelationshipMotherFatherLegal GuardianSecondary Phone Secondary Email Secondary AddressSame as PrimaryAdd Secondary AddressSecondary AddressAddress Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeSecondary Occupation & Place of Employment Secondary Work Phone DemographicsHispanic? *yesnoEthnicity *American Indian / Native AlaskanAsianBlack or African AmericanHispanic or LatinoMulti RacialNative Hawiian / Pacific IslanderWhitePrimary Language *EnglishSpanish AfrikaansAlbanianArabicBasqueBelarusanBengaliBhojpuriBislamaBosnianBrahuiBulgarianBurmeseCantoneseCatalanCebuanoChechenCherokeeCroatianCzechDakotaDanishDariDholuoDutchEstonianFinnishFrenchGeorgianGermanGreekHaitianCreoleHawaiianHebrewHiligaynonHindiHungarianIcelandicIndonesianInuit/InupiaqIrish GaelicItalianJapaneseKazakhKoreanLatvianLingalaLithuanianMacedonianMandarinMongolianNahuatlNavajoNepaliNorwegianOjibwaOriyaOromoPashtoPersianPolishPortuguesePunjabiQuechuaRomaniRomanianRussianRwandaSamoanSanskritSerbianShonaSindhiSinhalaSlovakSloveneSomaliSwahiliSwedishTachelhitTagalogTajikiTamilTatarTeluguThaiTibeticTurkishUkrainianUrduUyghurUzbekVietnameseWarlpiriWelshWolofXhosaYakutYiddishYorubaYucatecZapotecZuluSecondary Language EnglishSpanish AfrikaansAlbanianArabicBasqueBelarusanBengaliBhojpuriBislamaBosnianBrahuiBulgarianBurmeseCantoneseCatalanCebuanoChechenCherokeeCroatianCzechDakotaDanishDariDholuoDutchEstonianFinnishFrenchGeorgianGermanGreekHaitianCreoleHawaiianHebrewHiligaynonHindiHungarianIcelandicIndonesianInuit/InupiaqIrish GaelicItalianJapaneseKazakhKoreanLatvianLingalaLithuanianMacedonianMandarinMongolianNahuatlNavajoNepaliNorwegianOjibwaOriyaOromoPashtoPersianPolishPortuguesePunjabiQuechuaRomaniRomanianRussianRwandaSamoanSanskritSerbianShonaSindhiSinhalaSlovakSloveneSomaliSwahiliSwedishTachelhitTagalogTajikiTamilTatarTeluguThaiTibeticTurkishUkrainianUrduUyghurUzbekVietnameseWarlpiriWelshWolofXhosaYakutYiddishYorubaYucatecZapotecZuluAcademicsHas the student had any of the following academic testing/evaluations?ADD/ADHDGifted/TalentedMathMultifactoredPsychologicalReadingSpeech/languageUpload Evaluation DocumentationHas the student been enrolled in any special programs in or out of school?Gifted/EnrichmentRemedial MathRemedial ReadingSpeech/LanguageTutoringTitle IHas the studenthad/has IEPBeen RetainedPrescribed MedicationIf you chose one or more options, please specify the area/give more detail belowSubmit