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Student Enrollment Form 2021-22

Please complete the form below. Required fields marked with an asterisk * If any of the following information changes during the school year, please  notify us immediately. 

 

Gender*
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Primary Language Spoken at Home*
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Heritage (Optional)
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Previous School Information

Please upload the following forms that GLCPS is required to have on file for each student: 1.) Student's Birth Certificate; 2.) Student's Final 4th Grade Report Card; 3.) Copy of Student's Physical Examination and Immunization Record (Physical exams must be completed within 13 months prior to the start of school.
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If your child has an IEP or 504 plan, please upload the document here.
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Parent/Guardian Information

Primary Parent/Guardian Information 

Does the student live with this person?*
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Please provide me written information in this language.
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Please communicate orally with me in this language.
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May this child be released to this parent?
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Primary Parent/Guardian #2 Information 

Does the student live with this person?
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Please provide me written information in this language.
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Please communicate orally with me in this language.
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May this child be released to this parent?
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Student Health Information

For students who need medication at school, our school's medication policy requires your child's doctor to complete a Medication Order Form for all prescription medications, including some over-the-counter products.  In addition to the physician filling out the Medication Order, you must complete an Authorization for Dispensing Medication Form and a Field Trip Medical Consent Form. These forms are available in the Health Services section of our website, www.glcps.org. On the website, on the 'GLCPS Life' tab, go to 'Health Services', scroll down and click on the 'Health Forms & Resources' link. You will find the appropriate forms in ‘Student Medical and Health Care Forms,’ where you can download and print the appropriate forms to complete and deliver to the school nurse or upload through this portal.We will accept a medication order form specific to your Dr’s office as well. Please contact the school nurse if you have any questions.

 

Please check all that applies to your child.
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Can your child participate in the school's physical education program?*
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Please check the box on all the medications/creams/ointments/sprays that you authorize the nurse to administer or apply to your child.
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I understand that this information is confidential. However, federal law permits information in the school health record to be shared with school officials on a "Need to Know" basis and with a very limited number of other persons, including those who could help in an emergency. In other circumstances, my consent will be required. I give permission to exchange information with my child's health care provider. I understand that I can limit or revoke this consent at any time. 

Emergency Dismissal Information

Designated people to contact in order of preference, if primary parent/guardian is not available. 

No student will be dismissed to a person who does not have proper identification. If any custody documents or court orders are in effect, please attach a copy to this form in order for us to honor them.
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Emergency Closing Permission Slip

In the case of an Emergency Closing of School after the children have already arrived for the day, this Permission Slip gives us your permission to dismiss your child using the method you prefer. Please fill out your choice and download your signature. Please be sure to fill out one for each of your children. 

In case of an emergency, you will received a GLCPS automated phone call informing you of our closing. Then, the following permission will be followed. 

 

My child has permission to do one of the following. (Please check one.)
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