EVSC Parent Access
Privacy Policy
* Field is required
Request for Enrollment
Thank you for choosing the Evansville Vanderburgh School Corporation in Evansville, Indiana!
Please Note
: This form should be used to register any student to a school in the EVSC.
Have Documents Ready!
Please have your child's birth certificate, immunization records, and proof of Indiana residency (utility bill, mortgage statement, lease agreement, etc...) ready for upload on the next screen. Pictures or scanned copies of the documentation are acceptable.
Your request will be routed to your school of residence.
The school will review the request and contact you with additional information.
Need Extended Daycare?
There is an application process for daycare. Please visit
Extended Daycare
for more information.
Need Bus transportation? Bus must be applied for and is NOT guaranteed.
This form will not request bus transportation for your child. Please visit
Bus Application
for more information.
If you are enrolling for the Next School Year (2023-2024), please note that in the comment box at the bottom of this form.
Student's Legal Last Name
*
Student's Legal First Name
*
Student Middle Name
*
N/A
Student Suffix (Jr., Sr.)
Grade
*
PK
KG
01
02
03
04
05
06
07
08
09
10
11
12
Student Birthdate
*
mm/dd/yyyy
Gender
*
Female
Male
Student Social Security
Student Place of Birth (City/State) (If outside US/Canada use City textbox for City/State)
*
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
AB
BC
MB
NB
NL
NS
NT
NU
ON
PE
QC
SK
YT
Does your child have an Individualized Education Plan (IEP)?
*
No
Yes
What will be your child's mode of transportation for the upcoming school year?
*
Bus
Car Rider
Walk
Undecided
Student Home Address
*
Student Home Apartment
Student Home City/State
*
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
AB
BC
MB
NB
NL
NS
NT
NU
ON
PE
QC
SK
YT
Student Home Zip
*
Student Home Phone
*
Student Lives With
*
MOTHER
FATHER
ADOPTED MOTHER
ADOPTED FATHER
FOSTER MOTHER
FOSTER FATHER
GRANDMOTHER
GRANDFATHER
3RD PARTY CUSTODIAN
COURT APPOINTED CUSTODIAN
DCS CASEWORKER
FOREIGN EXCHANGE HOST FAMILY
YOUTH HOME STAFF
Alone
Adoptive Parents
Father & Father
Foster Home
Father & Mother
Father only
Father & Stepmother
Grandparent
Mother & Mother
Mother only
Mother & Stepfather
Nursing Home
Other
Father & Stepfather
Mother & Stepmother
Ward of Court
Ward of Dept of Mental Health
Ward of Dept Public Welfare
Student Custody/Guardianship
*
MOTHER
FATHER
ADOPTED MOTHER
ADOPTED FATHER
FOSTER MOTHER
FOSTER FATHER
GRANDMOTHER
GRANDFATHER
3RD PARTY CUSTODIAN
COURT APPOINTED CUSTODIAN
DCS CASEWORKER
FOREIGN EXCHANGE HOST FAMILY
YOUTH HOME STAFF
Alone
Adoptive Parents
Father & Father
Foster Home
Father & Mother
Father only
Father & Stepmother
Grandparent
Mother & Mother
Mother only
Mother & Stepfather
Nursing Home
Other
Father & Stepfather
Mother & Stepmother
Ward of Court
Ward of Dept of Mental Health
Ward of Dept Public Welfare
Parent/Guardian(s)
*
You must enter information for at least one legal parent/guardian, but may enter up to two.
Legal Parent/Guardian 1 Last Name
Legal Parent/Guardian 1 First Name
Legal Parent/Guardian 1 Phone
Legal Parent/Guardian 1 Email
Legal Parent/Guardian 1 Address
(if different from student)
Legal Parent/Guardian 1 Apartment
Legal Parent/Guardian 1 City/State
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
AB
BC
MB
NB
NL
NS
NT
NU
ON
PE
QC
SK
YT
Legal Parent/Guardian 1 Zip
Legal Parent/Guardian 2 Last Name
Legal Parent/Guardian 2 First Name
Legal Parent/Guardian 2 Phone
Legal Parent/Guardian 2 Email
Legal Parent/Guardian 2 Address
(if different from student)
Legal Parent/Guardian 2 Apartment
Legal Parent/Guardian 2 City/State
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
AB
BC
MB
NB
NL
NS
NT
NU
ON
PE
QC
SK
YT
Legal Parent/Guardian 2 Zip
Work Information
Employer Name
Address
City/State
Phone
Parent/Guard 1 Work
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
AB
BC
MB
NB
NL
NS
NT
NU
ON
PE
QC
SK
YT
Parent/Guard 2 Work
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
AB
BC
MB
NB
NL
NS
NT
NU
ON
PE
QC
SK
YT
Emergency/Contact Information
Name
Address
City/State
Phone
1
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
AB
BC
MB
NB
NL
NS
NT
NU
ON
PE
QC
SK
YT
2
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
AB
BC
MB
NB
NL
NS
NT
NU
ON
PE
QC
SK
YT
3
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
AB
BC
MB
NB
NL
NS
NT
NU
ON
PE
QC
SK
YT
4
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
AB
BC
MB
NB
NL
NS
NT
NU
ON
PE
QC
SK
YT
Doctor Name
Doctor Phone
Dentist Name
Dentist Phone
Babysitter/Daycare
Babysitter/Daycare Phone
Last School Attended
*
Has your child ever been enrolled in an Indiana school?
*
No
Yes
School or Preschool Name
(enter "none" if no last school or preschool)
City/State
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
AB
BC
MB
NB
NL
NS
NT
NU
ON
PE
QC
SK
YT
Phone
Ethnicity
*
Is this student Hispanic Latino?
No
Yes
Race
*
Choose all that apply.
American Indian/Alaska Native
Asian
Black/African American
Hispanic/Latino (Use Above Ethnicity Option)
Native Hawaiian/Pacific Islander
White
Siblings Enrolled at This District
Name
School
Grade
AIS Diamond
Bosse High School
Caze Elementary School
Cedar Hall K-8 School
Central High School
Culver Early Childhood Center
Cynthia Heights Elementary School
Daniel Wertz Elementary School
Delaware Elementary School
Dexter Elementary School
Evans School
Even Start Adult GED Program and Their Kids
EVSC Virtual Academy
Fairlawn Elementary School
Glenwood K-8 School
Harper Elementary School
Harrison High School
Harwood Career Prep High School
Hebron Elementary School
Helfrich Park STEM Academy
Highland Elementary School
Lincoln K-8 School
Lodge K-8 School
McCutchanville Elementary School
McGary Middle School
New Tech Institute
North High School
North Junior High School
Oak Hill Elementary School
Perry Heights Middle School
Plaza Park International Prep Academy
Reitz High School
Scott Elementary
Stockwell Elementary School
Stringtown Elementary School
Tekoppel Elementary School
The Learning Center
Thompkins Middle School
Vogel Elementary School
Washington Middle School
West Terrace Elementary School
01
02
03
04
05
06
07
08
09
10
11
12
13
CR
GR
KG
P0
P1
P2
P3
P4
PA
PP
SE
AIS Diamond
Bosse High School
Caze Elementary School
Cedar Hall K-8 School
Central High School
Culver Early Childhood Center
Cynthia Heights Elementary School
Daniel Wertz Elementary School
Delaware Elementary School
Dexter Elementary School
Evans School
Even Start Adult GED Program and Their Kids
EVSC Virtual Academy
Fairlawn Elementary School
Glenwood K-8 School
Harper Elementary School
Harrison High School
Harwood Career Prep High School
Hebron Elementary School
Helfrich Park STEM Academy
Highland Elementary School
Lincoln K-8 School
Lodge K-8 School
McCutchanville Elementary School
McGary Middle School
New Tech Institute
North High School
North Junior High School
Oak Hill Elementary School
Perry Heights Middle School
Plaza Park International Prep Academy
Reitz High School
Scott Elementary
Stockwell Elementary School
Stringtown Elementary School
Tekoppel Elementary School
The Learning Center
Thompkins Middle School
Vogel Elementary School
Washington Middle School
West Terrace Elementary School
01
02
03
04
05
06
07
08
09
10
11
12
13
CR
GR
KG
P0
P1
P2
P3
P4
PA
PP
SE
AIS Diamond
Bosse High School
Caze Elementary School
Cedar Hall K-8 School
Central High School
Culver Early Childhood Center
Cynthia Heights Elementary School
Daniel Wertz Elementary School
Delaware Elementary School
Dexter Elementary School
Evans School
Even Start Adult GED Program and Their Kids
EVSC Virtual Academy
Fairlawn Elementary School
Glenwood K-8 School
Harper Elementary School
Harrison High School
Harwood Career Prep High School
Hebron Elementary School
Helfrich Park STEM Academy
Highland Elementary School
Lincoln K-8 School
Lodge K-8 School
McCutchanville Elementary School
McGary Middle School
New Tech Institute
North High School
North Junior High School
Oak Hill Elementary School
Perry Heights Middle School
Plaza Park International Prep Academy
Reitz High School
Scott Elementary
Stockwell Elementary School
Stringtown Elementary School
Tekoppel Elementary School
The Learning Center
Thompkins Middle School
Vogel Elementary School
Washington Middle School
West Terrace Elementary School
01
02
03
04
05
06
07
08
09
10
11
12
13
CR
GR
KG
P0
P1
P2
P3
P4
PA
PP
SE
AIS Diamond
Bosse High School
Caze Elementary School
Cedar Hall K-8 School
Central High School
Culver Early Childhood Center
Cynthia Heights Elementary School
Daniel Wertz Elementary School
Delaware Elementary School
Dexter Elementary School
Evans School
Even Start Adult GED Program and Their Kids
EVSC Virtual Academy
Fairlawn Elementary School
Glenwood K-8 School
Harper Elementary School
Harrison High School
Harwood Career Prep High School
Hebron Elementary School
Helfrich Park STEM Academy
Highland Elementary School
Lincoln K-8 School
Lodge K-8 School
McCutchanville Elementary School
McGary Middle School
New Tech Institute
North High School
North Junior High School
Oak Hill Elementary School
Perry Heights Middle School
Plaza Park International Prep Academy
Reitz High School
Scott Elementary
Stockwell Elementary School
Stringtown Elementary School
Tekoppel Elementary School
The Learning Center
Thompkins Middle School
Vogel Elementary School
Washington Middle School
West Terrace Elementary School
01
02
03
04
05
06
07
08
09
10
11
12
13
CR
GR
KG
P0
P1
P2
P3
P4
PA
PP
SE
AIS Diamond
Bosse High School
Caze Elementary School
Cedar Hall K-8 School
Central High School
Culver Early Childhood Center
Cynthia Heights Elementary School
Daniel Wertz Elementary School
Delaware Elementary School
Dexter Elementary School
Evans School
Even Start Adult GED Program and Their Kids
EVSC Virtual Academy
Fairlawn Elementary School
Glenwood K-8 School
Harper Elementary School
Harrison High School
Harwood Career Prep High School
Hebron Elementary School
Helfrich Park STEM Academy
Highland Elementary School
Lincoln K-8 School
Lodge K-8 School
McCutchanville Elementary School
McGary Middle School
New Tech Institute
North High School
North Junior High School
Oak Hill Elementary School
Perry Heights Middle School
Plaza Park International Prep Academy
Reitz High School
Scott Elementary
Stockwell Elementary School
Stringtown Elementary School
Tekoppel Elementary School
The Learning Center
Thompkins Middle School
Vogel Elementary School
Washington Middle School
West Terrace Elementary School
01
02
03
04
05
06
07
08
09
10
11
12
13
CR
GR
KG
P0
P1
P2
P3
P4
PA
PP
SE
AIS Diamond
Bosse High School
Caze Elementary School
Cedar Hall K-8 School
Central High School
Culver Early Childhood Center
Cynthia Heights Elementary School
Daniel Wertz Elementary School
Delaware Elementary School
Dexter Elementary School
Evans School
Even Start Adult GED Program and Their Kids
EVSC Virtual Academy
Fairlawn Elementary School
Glenwood K-8 School
Harper Elementary School
Harrison High School
Harwood Career Prep High School
Hebron Elementary School
Helfrich Park STEM Academy
Highland Elementary School
Lincoln K-8 School
Lodge K-8 School
McCutchanville Elementary School
McGary Middle School
New Tech Institute
North High School
North Junior High School
Oak Hill Elementary School
Perry Heights Middle School
Plaza Park International Prep Academy
Reitz High School
Scott Elementary
Stockwell Elementary School
Stringtown Elementary School
Tekoppel Elementary School
The Learning Center
Thompkins Middle School
Vogel Elementary School
Washington Middle School
West Terrace Elementary School
01
02
03
04
05
06
07
08
09
10
11
12
13
CR
GR
KG
P0
P1
P2
P3
P4
PA
PP
SE
AIS Diamond
Bosse High School
Caze Elementary School
Cedar Hall K-8 School
Central High School
Culver Early Childhood Center
Cynthia Heights Elementary School
Daniel Wertz Elementary School
Delaware Elementary School
Dexter Elementary School
Evans School
Even Start Adult GED Program and Their Kids
EVSC Virtual Academy
Fairlawn Elementary School
Glenwood K-8 School
Harper Elementary School
Harrison High School
Harwood Career Prep High School
Hebron Elementary School
Helfrich Park STEM Academy
Highland Elementary School
Lincoln K-8 School
Lodge K-8 School
McCutchanville Elementary School
McGary Middle School
New Tech Institute
North High School
North Junior High School
Oak Hill Elementary School
Perry Heights Middle School
Plaza Park International Prep Academy
Reitz High School
Scott Elementary
Stockwell Elementary School
Stringtown Elementary School
Tekoppel Elementary School
The Learning Center
Thompkins Middle School
Vogel Elementary School
Washington Middle School
West Terrace Elementary School
01
02
03
04
05
06
07
08
09
10
11
12
13
CR
GR
KG
P0
P1
P2
P3
P4
PA
PP
SE
Comments or Additional Information
Signature
Full Name of Registering Adult
*
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