Common Contracts
1 similar Office Use contracts
ContractOffice Use • December 9th, 2021
Perry Township Schools6548 Orinoco Avenue ∙ Indianapolis, Indiana 46227 ∙ 317.789.3700 School Name/Code STUDENT ENROLLMENT & EMERGENCY CONSENT FORM 22-23 Enrollment Date (mm/dd/ccy) Current Grade (based on # of years in H.S. if applicable) Graduation Year STUDENT INFORMATION Last First MiddleLineage (i.e. Jr, I, II, etc.) Male Female DOBStreet Address City State ZipCode Is the name or rental agreement for the address listed in your name Yes No STUDENT BIRTH INFORMATION Place of Birth: City State CountyBorn Outside of U.S.? Yes No If yes, which country Is the student a refugee? I-94U.S. Arrival Date Resettlement Agencies (Select One) Catholic Charities Exodus Out of State Agency PARENT/GUARDIAN CONTACT INFORMATION Parent/Guardian 1 Parent/Guardian 2 NameRelationship to StudentAddressCity, State, ZipHome # Work #Cell #Preferred Email NameRelationship to StudentAddressCity, State, ZipHome # Work #Cell #Preferred Email STUDENT LIVES WITH: Who is Legal Guardian and/or has Legal Custody
