County School Enrollment Services Request

County School Enrollment Services Request
Submit your request to enroll a student in county schools. Please provide all required information to process your application efficiently.
Student Full Name
First NameLast Name
Student Date of Birth
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Student Address
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Grade Applying For
Parent/Guardian Full Name
First NameLast Name
Parent/Guardian Email Address
example@example.com
Parent/Guardian Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Preferred School(s) for Enrollment
Other (please specify)
Previous School Attended (if any)
Upload Supporting Documents (proof of residence, previous school records, etc.)
Cancelof
Does the student require any special services?
Other (please specify)
Emergency Contact Name
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Additional Comments or Requests
Should be Empty: