registration | SCA

WELCOME TO 2020 – 2021 STUDENT REGISTRATION FORM!

This form has to be completed for every student.

Today's date*
Date Format: MM slash DD slash YYYY
Student's Full Name*
First Last
Gender*
- Male
- Female
Address*
Street Address Address Line 2 City State ZIP Code
Completed grade*
Grade to be registered*
Student's age on September 10th*
Date of birth*
Date Format: MM slash DD slash YYYY
Mother's Full Name*
First Last
Cell phone number*
Email
Father's Full Name
First Last
Email
Cell phone number
Other than parents emergency contact 1
Relationship
Phone number
Other than parents emergency contact 2
Relationship
Phone number
What is the student's primary language?
Does the student speak English?*
- Yes
- No
Is the student being transferred from another school?*
- Yes
- No
Name of the school transferring from
Finished grade
School address
School phone number
Does the student have any medical issues or allergies?*
- Yes
- No
Please, explain in detail:
Signature*