Student Data Collection

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Student Information:

The following student information MUST match student's birth certificate.
Gender *
 +
Unlisted?
Is the student Hispanic? *
From the racial categories below, mark one or more races with which the student identifies. *
Is this student new to Monongalia County Schools? *
PLEASE NOTE:
In addition to completing this form, it is important that you also contact your student's new school to ensure all enrollment steps are completed. Completing this form is an important component of new student enrollment but it is not enough by itself! *
 

Confidential Information:


Is there a current Order of Protection or No Contact Order which concerns this student? *
 *

Parent/Guardian Information:

NOTE: Any Custody Restrictions Must Be Documented By A Court Order. A Copy Of Court Order Must Be Provided To The School Office.
Student lives with: *
If student lives with a guardian, there may be resources available to help. Please provide more information (optional). You may select more than one.
 
Parent/Legal Guardian 1:
If you do not have an email address, you may obtain one for free in several ways. Here are a few links that can help you get started, but there are many excellent free email providers and these are not the only ones we can recommend.
 
Yahoo and Hotmail emails are not encouraged because they are the least secure and are often blocked by our state/school email filter.
Parent/Legal Guardian 2:

Military Connected Status

Please check any duty status below that applies to a parent/guardian of the student: * 🛈

Emergency Information

Please identify person(s) other than parent or guardian who could be contacted in case you cannot be reached. Anyone who is authorized to pick up your child from school should also be listed.
Emergency Contact 1:
Emergency Contact 2:
Emergency Contact 3:
Emergency Contact 4:
EMERGENCY USE ONLY:
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