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New student information

 

Name:   
                 First                                       Middle                                  Last
Birth Date:   
                         Month                                Day                                         Year

Home Address:   
                                 Street                         City                  Zip Code

Phone Number:  Secondary Phone Number:
                                  e.g 123-456-7890

Email Address of Parent/Guardian:

 

Does the student have a sibling currently attending Madison District Schools under the schools of choice program? yes no    Name of sibling:

 

Current grade of student Pre-K  10  11  12

School District of Home Address:  Name of Current School:

Which school are you applying to? 

Madison Early Childhood Center (MECC)

Madison Elementary School (MES)

Wilkinson Middle School (WMS)

Madison High School (MHS)

Madison Preparatory High School (Prep)

SOARCE

How did you hear about Madison District Public Schools?

Has the student been suspended from school within the last two school years? yes no

Has the student ever been expelled from school? yes no

Does this student have any special needs? yes no        Does the student have an I.E.P.? yes no

I understand that by typing my name I am signing this application. I certify all of the information provided above to be true and correct. I acknowledge and accept the policies and stipulations of the Madison District Schools. I understand false or incomplete information will result in the removal of the applicant from Madison Schools programs.

Full name of parent or guardian: Date:



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