New Student Online Enrollment Application

Student Information
Student Name *
Student Name
Birthday *
Birthday
Primary Phone Number *
Primary Phone Number
Address *
Address
Student Race *
Has Your Student Ever:
Parent / Guardian 1
Parent / Guardian 1 Name *
Parent / Guardian 1 Name
Cell Phone
Cell Phone
Work Phone
Work Phone
Parent / Guardian 2
Parent / Guardian 2 Name
Parent / Guardian 2 Name
Cell Phone
Cell Phone
Work Phone
Work Phone
Student Housing and Transportation
Busing is available for families living in Saint Paul and parts of Minneapolis, Roseville and Woodbury)
Please write the names of all adults who are allowed to pick up the student.
Sibling Information
Emergency Contact Info
Emergency Contact 1 *
Emergency Contact 1
Cell Phone *
Cell Phone
Emergency Contact 2
Emergency Contact 2
Cell Phone
Cell Phone
Home Language Information
Student Health Information
Does the studnet have any health concenrs of which the school should be aware of?
Does the student wear glasses or contact lenses?
Media Release
Signature