Marcus Whitman UPK & Kindergarten Pre-Registration Form

Required

Welcome to the Whitman Family! Thank you for filling out this pre-registration form. This information helps us in planning for the best start to school in September. To be eligible for UPK this coming school year, your child must be 4 years old by December 1. Incoming kindergarteners must be 5 years old by December 1. All students enrolling in the district must reside inside our borders. Proof of birthdate, residence and any relevant court paperwork will need to be provided with the formal registration paperwork.

Students Name*required

First Name

Middle (optional)

Last Name

Sex*required

Male

Female

Non Binary

Date of Birth*required

Must contain a date in M/D/YYYY format

Ethnicity*required

What adults does this student live with?*required

First Name

Last Name

Phone Number*required

Alt Phone Number

Email Address

Relation*required

Is there another adult in the household?*requiredSelect yes if there is another adult responsible for this student.

Yes

Select yes if there is another adult responsible for this student.

Another Adult*required

First Name

Last Name

Phone Number*required

Alt Phone Number*required

Email Address*required

Relation*required

Address where student lives*required

123 Main St

City/Town/Hamlet*required

Gorham

State*required

New York

Zip Code*required

14554

Is there a separate mailing address?*required

Yes

Mailing Address

123 Main St

City/Town/Hamlet

Gorham

State

New York

Zip Code

14554

Any other children in the house?*required

Yes

Other childrens names and ages

Is there any court or custody paperwork associated with this student?*required

Yes

Does the Student have an IEP or 504 plan?*required

Yes

Does the student have permanent, fixed & adequate housing?*required

Yes

What is the Home Language for this student?*required

English

Other

Is there medical or any other information we should be aware of?*required

Yes

Please describe medical infomation further

*All students should have a recent physical and updated immunizations to begin school.*

This form is the first part of our UPK registration process. The complete enrollment packet will be sent to you.

If you have any questions, please contact Dr. Clayton Cole at 585-554-6441 x1444 or ccole@mwcsd.org

Welcome to Whitman!