Header EVSC Parent Access
* Field is required
Request for Enrollment


Thank you for choosing the EVSC!

Please Note: This form should be used to register any student to a school in the EVSC for the 2020-21 school year.

  • Please complete all required fields (noted with a red asterisk)
  • Enter any additional comments or pertinent information at the bottom of the form
  • Submit the form by clicking on the Save and Finish button at the bottom of the form
  • Your registration information will then be sent to your school of residence
  • Someone at the school will review your registration and then contact you with additional information required to complete Part 2 & 3 of the enrollment process
Student Last Name *
Student First Name *
Student Middle Name  
Grade *
Gender *
Birthdate * mm/dd/yyyy
Student Social Security
Place of Birth (City/State) *  
Address *
Apartment  
City/State *  
Zip *
Home Phone *
Lives With *
     
Mother/Father *
You must enter information for at least one parent.
Mother Last Name
Mother First Name  
Mother Phone
Mother Email
Mother Address
(if different from student)
Mother Apartment  
Mother City/State  
Mother Zip  
     
Father Last Name
Father First Name  
Father Phone
Father Email
Father Address
(if different from student)
Father Apartment  
Father City/State  
Father Zip  
Work Information
  Employer Name Address City/State Phone
Mom Work  
Dad Work  
Emergency/Contact Information
  Name Address City/State Phone
1  
2  
3  
4  
Doctor Name  
Doctor Phone
Dentist Name  
Dentist Phone
Babysitter/Daycare  
Babysitter/Daycare Phone
Last School Attended *
School Name
(enter "none" if no last school)
City/State  
Phone
Ethnicity *
Check all that apply. You must check at least one.
   
   
   
   
   
   
Siblings Enrolled at This District
Name School Grade
Comments or Additional Information
Signature
Your Name *
 
     
     
     
         
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