NC WISE Registration Form
PowerSchool Registration Form (complete front and back)
|SCHOOL OFFICE USE ONLY |
| |Birth Certificate |
|NCWise Number: | |Address: | |
|*Office Use Only* | | | |
|Legal Last Name: | |City: | |
|Legal First Name: | |Zip: | |
|Middle Name: | | |
|Birth Date: | |MAILING ADDRESS: |
|Country of Birth: | |Address: | |
|Social Security: | |City: | |
|Home Phone: | |Zip: | |
|Gender: | Male Female | | |
|Ethnicity: | Hispanic Non-Hispanic | | |
|Race: | Asian African-American American Indian Hawaiian/Pacific Islander White |
|PARENT/GUARDIAN INFORMATION |
|Child Lives With: | Mother Father Stepmother Stepfather Foster Parents Guardian Other: |
|Legal Custody: | Mother Father Stepmother Stepfather Foster Parents Guardian Other: |
|Mother: | |Father: | |
|Address/City/Zip: | |Address/City/Zip: | |
|Home Phone: | |Home Phone: | |
|Employer/Squadron: | |Employer/Squadron: | |
|Position/Rank: | |Position/Rank: | |
|Work Phone: | |Work Phone: | |
|Cell Phone: | |Cell Phone: | |
|Email Address: | |Email Address: | |
|Educational Level: | |Educational Level: | |
|Migrant Worker: | Yes No |Migrant Worker: | Yes No |
|EMERGENCY CONTACTS |
| |Contact 1 |Contact 2 |
|Full Name: | | |
|Relationship to Student: | | |
|Home Phone: | | |
|Work Phone: | | |
|Cell Phone: | | |
|MEDICAL |
|Doctor: | |
|Medications: | |
|SPECIAL NEEDS: |
| |IEP (Individualized Education Plan) | |PEP (Personalized Education Plan) |Other: |
| |504 (Accommodation Plan) | |AIG (Academically/Intellectually Gifted) |Other: |
|SIBLINGS: |
|Name: | |School: | |Grade: | |
|Name: | |School: | |Grade: | |
|Name: | |School: | |Grade: | |
|Name: | |School: | |Grade: | |
|MILITARY INFORMATION |
|Name |Rank |Relationship to Student |Branch of Service |Squadron/Unit |
| | | | | |
| | | | | |
| | | | | |
| | | | | |
|OTHER |
|Has this student ever attended a Wayne County public school? | Yes No |
|If yes, please give the name of the schools: | |
| | |
|I am aware that I must provide within 30 calendar days the item indicated to avoid suspension. | Yes No |
| | | |
| | | |
|Signature | |Date |
| | | |
| | | |
| | | |
| | | |
| | | |
|Comments: | | |
| | | |
| | | |
| | | |
................
................
In order to avoid copyright disputes, this page is only a partial summary.
To fulfill the demand for quickly locating and searching documents.
It is intelligent file search solution for home and business.
Related download
- iblog teacher websites dearborn public schools
- nc wise registration form
- current listing of additional skill identifiers asi and
- states home u s department of education
- wsfcs 8th grade pacing at a glance
- master schedule 2020 2021 charlotte mecklenburg schools
- the bylaws of the nc child nutrition procurement alliance
- wayne county public schools
- home connect ncdot
Related searches
- nevada business registration form online
- medical marijuana registration form pa
- vanguard account registration form pdf
- new patient registration form template
- patient registration form microsoft word
- patient registration form word document
- medical patient registration form template
- patient registration form word document free
- patient registration form template
- business registration form jamaica
- nj dmv registration form pdf
- combined employers registration form oregon