Online Student Enrollment V4

Online Student Enrollment

Version 4 - September 9, 2024
Welcome to the Student Enrollment Form

This form collects essential information about your student for the upcoming school year.

What to Expect
- (Required) Student Demographics: Name, birthdate, anticipated grade and start, and any support plans (IEP, 504).
- (For new students) Home Language Survey: Information about your household language.
- (Required) Parent/Guardian Information: Contact details and relationships.
- (Required) Address Information: Where the student lives and where to send mail.
- (Conditionally Optional) Emergency Contacts: Who to contact in case of an emergency. At least two are required for Pre-K registrations.
- (Required) Medical Information: Health conditions, medications, and allergies.
- (Required) Daily Transportation / End-of-Day Plans: How your student gets to/from school and their end-of-day routine.
- (Required) Permissions / Acknowledgements: Your choices on information sharing, media, field trips, and early dismissal.
- (Optional) Household Income Form: This helps us secure federal funding.
- (Optional) Survey Info: Details about other children in the household, internet access, and other services.
- Document Uploads (If Available)
- Final Review and Submit
Which school is this for?*
Is this a new or returning student?*

School Information

Student Demographics
Student Legal Name (This should match their birth certificate)*

First NameMiddle NameLast Name
Student Preferred Name (Optional)

First NameLast Name
Federal Gender Reporting*
This information is required for federal reporting purposes. This should match their birth certificate.
Gender Identity (Optional)
We aim to be inclusive of all gender identities. Please select the option that best describes your child or self-describe if not listed. This section is optional.
Gender Self-describe*
What are your student's preferred pronouns? (Optional)
Pronoun Self-describe*
Date of Birth*

MonthDayYear
Ethnicity*
Race (select all that apply)*

American Indian or Alaska NativeAsianBlack or African AmericanNative Hawaiian or Other Pacific IslanderWhite
Anticipated Grade Level*
Anticipated Start Date*

MonthDayYear
Does this student have a IEP or 504 Plan?*
Is this student under DCF Custody?*
Is this student considered McKinney-Vento (Experiencing Homelessness)?*
https://nche.ed.gov/legislation/mckinney-vento/
What is the student's primary language at home?*

EnglishSpanishOther

Home Language Survey
Student's Country of Birth*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Date of Entry in U.S. (Month/Day/Year):*

MonthDayYear
What language(s) are spoken in your home?*
What language do you most often speak to your child?*
What language does your child currently use most often at home?*
What is the native language of each parent/guardian?*
What language did your child first speak or understand?*
Former School
Name of Former School*
Former School Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Former School Phone Number
Please enter a valid phone number.

Parent/Guardian Information
First Parent/Foster/Guardian
Parent/Foster/Guardian Name:*

First NameLast Name
Relationship to student*
Legal Custody?*
Other Relationship
Primary Email
example@example.com
Mobile Number
Please enter a valid phone number.
Can we text your mobile number?
Home Number
Please enter a valid phone number.
Which number do you prefer the school use for contact and automatic notifications?
Employer
Work Number (For Emergency Use)
Please enter a valid phone number.
Does this Parent/Foster/Guardian have permission to transport?*
Does the student live with this Parent/Foster/Guardian?
Second Parent/Foster/Guardian
Parent/Foster/Guardian Name:

First NameLast Name
Relationship to student
Legal Custody?
Other Relationship
Primary Email
example@example.com
Mobile Number
Please enter a valid phone number.
Can we text your mobile number?
Home Number
Please enter a valid phone number.
Which number do you prefer the school use for contact and automatic notifications?
Employer
Work Number (For Emergency Use)
Please enter a valid phone number.
Does this Parent/Foster/Guardian have permission to transport?
Does the student live with this Parent/Foster/Guardian?
Military Status
The State of Vermont requires that we collect this information.
Is anyone legally forbidden to access this student?
Would you like to add another Parent, Guardian, or Foster Parent record?

Additional Parent/Guardian Information
First Additional Parent/Foster/Guardian
Additional Parent/Foster/Guardian Name:*

First NameLast Name
Relationship to student*
Legal Custody?*
Other Relationship*
Primary Email
example@example.com
Mobile Number
Please enter a valid phone number.
Can we text your mobile number?
Home Number
Please enter a valid phone number.
Which number do you prefer the school use for contact and automatic notifications?
Employer
Work Number (For Emergency Use)
Please enter a valid phone number.
Does this Parent/Foster/Guardian have permission to transport?
Does the student live with this Parent/Foster/Guardian?
Second Additional Parent/Foster/Guardian
Additional Parent/Foster/Guardian Name:

First NameLast Name
Relationship to student
Legal Custody?
Other Relationship*
Primary Email
example@example.com
Mobile Number
Please enter a valid phone number.
Can we text your mobile number?
Home Number
Please enter a valid phone number.
Which number do you prefer the school use for contact and automatic notifications?
Employer
Work Number (For Emergency Use)
Please enter a valid phone number.
Does this Parent/Foster/Guardian have permission to transport?
Does the student live with this Parent/Foster/Guardian?

Address Information

Please enter where the student primarily resides. This is required as part of residency verification.
Physical Address*

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Is the mailing address the same as the physical address?*

YesNo
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Is this a change of address from past enrollments?*
Residency Verification: I attest that I physically reside and intend to remain domiciled at the address listed above. I understand that any attempt to falsify residency information is punishable under VT Statutes, Title 13, Section 3016. I further understand that the district may legally seek payment from me for any claims resulting from the falsification of residency information.*

Emergency Contacts

Please list who we should contact if parents/guardians can't be reached. You may add up to 3 emergency contacts. At least two are required for Pre-K registrations.
Emergency Contact #1
Name

First NameLast Name
Phone Number
Please enter a valid phone number.
Relationship to student
Does this contact have permission to transport?
Emergency Contact #2
Name

First NameLast Name
Phone Number
Please enter a valid phone number.
Relationship to student
Does this contact have permission to transport?
Emergency Contact #3
Name

First NameLast Name
Phone Number
Please enter a valid phone number.
Relationship to student
Does this contact have permission to transport?

Daily Transportation/End-Of-Day Plans

Students are not allowed to make end of day plan changes
Daily Transportation
What is the primary method that this student will get to school?*
End Of Day Plan
Monday
What is the student's primary transportation home?*
Where will the student be taking the bus to?*
Who is the approved adult(s) picking up the student?*
Is the student's end of day plan the same for each day?*
Tuesday
What is the student's primary transportation home on Tuesday?*
Where will the student be taking the bus to?*
Who is the approved adult(s) picking up the student?*
Wednesday
What is the student's primary transportation home on Wednesday?*
Where will the student be taking the bus to?*
Who is the approved adult(s) picking up the student?*
Thursday
What is the student's primary transportation home on Thursday?*
Where will the student be taking the bus to?*
Who is the approved adult(s) picking up the student?*
Friday
What is the student's primary transportation home on Friday?*
Where will the student be taking the bus to?*
Who is the approved adult(s) picking up the student?*
Unscheduled Early Release
In the event of an unscheduled early release, what should we do?*
Where will the student be taking the bus to?*
Who is the approved adult(s) picking up the student?*

Permissions/Acknowledgements
Under the Family Educational Rights and Privacy Act (FERPA), 20 U.S.C. § 1232g, the school may disclose 'directory' information such as a student's name, address, telephone number, date and place of birth, honors and awards, and dates of attendance without prior consent. However, parents and eligible students have the right to opt out of this disclosure.
Information Sharing
I allow the school to share this student's directory information, including achievements like honor roll or sports awards, publicly, in accordance with FERPA, 20 U.S.C. § 1232g.*
I allow this student to be photographed or recorded during school events and for those images to be shared publicly.*
Would you allow your student's photo to be included in the school's yearbook, and nowhere else?*
I allow this student's directory information to be shared with organizations like the Parent-Teacher Organizations (PTO), Project Graduation (for high school), and similar groups.*
Do you consent to having your child's information shared with Armed Forces recruiters and colleges?*
Under Section 9528 of the No Child Left Behind Act, Armed Forces recruiters and colleges can request the names, addresses, and phone numbers of students in grades 11 and 12.
Field Trips
I allow this student to participate in local field trips within WNESU, including visits to nearby schools and organizations such as libraries, museums, etc.*
I allow this student to attend general field trips off-campus and out of the area during the school year.*
Policy Acknowledgements
I acknowledge that I have received, read, and understand the student handbook. I agree to follow the policies and guidelines outlined within.*
I acknowledge that I have read, understand, and agree to abide by the terms of the Student Technology Acceptable Use Agreement (AUA).*

Survey Data (Optional)
Are there other children in the household?
This helps us project future enrollments.
What are their names and ages?
Do you have reliable internet connectivity at home?
Does your household have a computer or tablet?
How does your student typically feel about school?
Do you need assistance with school supplies or other resources?
What do you need help with?

Document Uploads
Upload Birth Certificate

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Upload Proof of Residence (Utility Bill/Lease/Mortgage/etc)

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Upload Immunization Records

Cancelof
Upload Parent/Guardian/Foster Parent Paperwork (If applicable)

Cancelof
Upload court documents relating to custody (if applicable)

Cancelof

Review
You're not done yet! Please review your submission by clicking below. You will still need to submit.
Should be Empty:

Name, Title	Email
Henry Bailly, Principal	henry.bailly@wnesu.com
Catherine (Cat) Seltzer, Assistant Principal	catherine.seltzer@wnesu.com
Beth Smith, Dean of Students	beth.smith@wnesu.com
Ainsley Bertone, Administrative Assistant	ainsley.bertone@wnesu.com
Kassandra Scheitlin, School Nurse	kassandra.scheitlin@wnesu.com

Name, Title	Email
Kelly O'Ryan, Principal	kelly.oryan@wnesu.com
Mark Gebo, Dean of Students	mark.gebo@wnesu.com
Rebecca Kobel, Administrative Assistant	rebecca.kobel@wnesu.com
Melanie LaRoss, School Counseling Administrative Assistant	melanie.laross@wnesu.com
Andrea Carlson, School Counselor	andrea.carlson@wnesu.com
Rosie DeCamp, School Counselor	rosie.decamp@wnesu.com
Whitney Patterson, School Nurse	whitney.patterson@wnesu.com

Name, Title	Email
Kerry Kennedy, Principal	kerry.kennedy@wnesu.com
Jen Cravinho, Administrative Assistant	jen.cravinho@wnesu.com

Name, Title	Email
Angela Cartier, Principal	angela.cartier@wnesu.com
Sarah Noble, Administrative Assistant	sarah.noble@wnesu.com
Desirae Wilbur, School Nurse	desirae.wilbur@wnesu.com

Name, Title	Email
Laura Hazard, Principal	laura.hazard@wnesu.com
Sara Wunderle, Administrative Assistant	sara.wunderle@wnesu.com
Jennifer Vaughan, School Nurse	jennifer.vaughan@wnesu.com

Name, Title	Email
Elizabeth Harty, Principal	elizabeth.harty@wnesu.com
Bridget Goodell, Administrative Assistant	bridget.goodell@wnesu.com
Kathleen Goodell, School Nurse	kathleen.goodell@wnesu.com

Name, Title	Email
Jennifer Keenan, Principal	jennifer.keenan@wnesu.com
Teresa Janiszyn, Administrative Assistant	teresa.janiszyn@wnesu.com

Online Student Enrollment

School Information

Student Demographics

Home Language Survey

Former School

Parent/Guardian Information

First Parent/Foster/Guardian

Second Parent/Foster/Guardian

Additional Parent/Guardian Information

First Additional Parent/Foster/Guardian

Second Additional Parent/Foster/Guardian

Address Information

Emergency Contacts

Emergency Contact #1

Emergency Contact #2

Emergency Contact #3

Medical Information

Asthma

Allergies

Diabetes/Seizures

Glasses/Contacts

Hearing Aids

Health insurance

Health Conditions

OTC Medication Permissions

Other Treatments

Physician Information

Authorizations

Medication Reminder

Daily Transportation/End-Of-Day Plans

Daily Transportation

End Of Day Plan

Monday

Tuesday

Wednesday

Thursday

Friday

Unscheduled Early Release

Permissions/Acknowledgements

Information Sharing

Field Trips

Policy Acknowledgements

Household Income (Optional)

Survey Data (Optional)

Document Uploads

Review